Comparison of Efficacy of Intravenous Palonosetron Versus Ondansetron and Dexamethasone for Prevention of Post-Operative Nausea and Vomiting (PONV) in Patients Undergoing Laparoscopic Surgeries

Abstract

Background: A high prevalence of PONV severely hinders a smooth recovery from anaesthesia and significantly increases postoperative patient discomfort. The introduction of numerous preventive antiemetic regimens in the late nineteenth century is known to be successful in lowering the incidence of the same, however there is scant evidence comparing ondansetron and Palonosetron, particularly when used for laparoscopic procedures.

Materials and methods: This is an analytical cross-sectional study, to be done in a total number of 50 patients who are posted for undergoing Laparoscopic surgeries under department of anaesthesia at Sree Balaji Medical College and Hospital, Chennai. Patients who were subjected to comparison of the respective two drugs were divided into two groups, group A- Palonosetron (0.075mg) IV and group B - Ondansetron (4mg) IV & Dexamethasone (4mg) IV and are then evaluated for effect on PONV. Patients are monitored and managed as per guidelines. Duration of post-operative Nausea and vomiting assessment and effects are noted in a comparative manner after observing the outcomes and the data will be analysed statistically.

Results: Mean age in group A is 48.47 and in group B it is 47.87.The two groups are comparable with respect to age (P>0.05). The two groups are comparable with respect to ASA grading (P>0.05). Extra antiemetic requirement is higher in group B than group A. There is difference is statistically significant between two groups with respect to Extra analgesia requirement (P=0.001).VAS score is better in group A compared to group B during all the assessment. There is statistically significant difference between both the groups with respect to VAS score from 6 to 24 hours (P<0.05). VCS score is better in group A compared to group B during all the assessment. There is statistically significant difference between both the groups with respect to VCS score from 6 to 24 hours (P<0.05).

Conclusion: Ondansetron has been often used for PONV prophylaxis, either alone or in combination with other medications, mostly due to its affordability. Contrarily, Palonosetron has a much higher affinity to the receptors and a greater half-life, resulting in an increased duration of activity that helps manage PONV better