Frequency of Postoperative Nausea and Vomiting after General Anesthesia in a Tertiary Care Hospital: A Comparison of Palonosetron and Dexamethasone
Shubhdeep Kaur, Chanpreet K Nagi, Anita Kumari, Ruchi Gupta
Dexamethasone, Laparoscopic cholecystectomy, Palonosetron, Postoperative nausea and vomiting
Citation Information :
Kaur S, Nagi CK, Kumari A, Gupta R. Frequency of Postoperative Nausea and Vomiting after General Anesthesia in a Tertiary Care Hospital: A Comparison of Palonosetron and Dexamethasone. Curr Trends Diagn Treat 2021; 5 (1):12-15.
Introduction: Postoperative nausea and vomiting (PONV) is an unpleasant sensation often described as worse than postoperative pain. Various drugs, including scopolamine, gabapentin, dexamethasone, metoclopramide, promethazine, haloperidol, and serotonin receptor antagonists, have been used for prophylaxis of PONV, but none has been 100% efficacious. We hereby try to compare the effects of palonosetron and dexamethasone on the frequency of PONV.
Aims and objectives: The aim of our study was to compare the frequency of PONV with palonosetron and dexamethasone in patients undergoing elective laparoscopic cholecystectomy surgery under general anesthesia.
Material and methods: In this prospective, randomized, double-blind study, 50 patients scheduled for laparoscopic cholecystectomy were randomized into two groups receiving 8 mg dexamethasone or 0.075 mg palonosetron. The frequency of PONV in the two groups was compared.
Results: Statistical analysis was done using SPSS version 20 (SPSS Inc., Chicago, Illinois, USA).The patients in the two groups were comparable in terms of mean age, body mass index, and gender distribution. At 4, 8, and 12 hours, the incidence of PONV was significantly less in patients receiving palonosetron than those receiving dexamethasone (p = 0.007, 0.001, 0.001, respectively).
Conclusion: We can conclude from the present study that 0.075 mg palonosetron is more effective than 8 mg dexamethasone to reduce the incidence of PONV after laparoscopic cholecystectomy.
Apfel CC, Laara E, Koivuranta M, et al. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology 1999;91(3):693–700. DOI: 10.1097/00000542-199909000-00022.
Gan TJ: Risk factors for postoperative nausea and vomiting. Anaesth Analg 2006; 102:1884-1898.doi: 0.1213/01.ANE.0000219597.16143.4D
Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology 1992;77(1):162–184. DOI: 10.1097/00000542-199207000-00023.
Fujii Y. Clinical strategies for preventing postoperative nausea and vomitting after middle ear surgery in adult patients. Curr Drug Saf 2008;3(3):230–239. DOI: 10.2174/157488608785699423.
Chun HR, Jeon IS, Park SY, et al. Efficacy of palonosetron for the prevention of postoperative nausea and vomiting: a randomised, double-blinded, placebo controlled trial. Br J Anaesth 2014;112(3):485–490. DOI: 10.1093/bja/aet340.
Morrow GR, Schwartzberg L, Barbour SY, et al. Palonosetron versus older 5-HT3 receptor antagonists for nausea prevention in patients receiving chemotherapy: a multi study analysis. J Commun Support Oncol 2014;12(7):250–258. DOI: 10.12788/jcso.0058.
Wang JJ, Ho ST, Liu YH, et al. Dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy. Br J Anaesth 1999;83(5):772–775. DOI: 10.1093/bja/83.5.772.
Larsson S, Lundberg D. A prospective survey of postoperative nausea and vomiting with special regard to incidence and relations to patient characteristics, anesthetic routines and surgical procedures. Acta Anaesthesiol Scand 1995;39(4):539–545. DOI: 10.1111/j.1399-6576.1995.tb04115.x.
Aroke EN, Hicks TL. Pharmacogenetics of postoperative nausea and vomiting. J Perianesth Nurs 2019;34(6):1088. DOI: 10.1016/j.jopan.2019.03.007.
Chatterjee A, Sahu S, Paul M, et al. Comparison of efficacy of palonosetron-dexamethasone combination with palonosetron or dexamethasone alone for prophylaxis against post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. Indian J Anaesth 2017;61(12):978–984. DOI: 10.4103/ija.IJA_317_17.
Tahir S, Mir AA, Hameed A. Effects of palonosetron and dexamethasone on postoperative nausea and vomiting in adult patients undergoing laparoscopic abdominal surgery: a randomized, double-blind, clinical trial at a tertiary care hospital. Int J Adv Med 2016;3(4):1048–1054. DOI: 10.18203/2349-3933.ijam20163747.
Pierre S, Whelan R. Nausea and vomiting after surgery. CEACCP 2013;13(1):28–32. DOI: 10.1093/bjaceaccp/mks046.
Shaikh SI, Nagarekha D, Hegade G, et al. Postoperative nausea and vomiting: a simple yet complex problem. Anesth Essays Res 2016;10(3):388–396. DOI: 10.4103/0259-1162.179310.