Randomised Control Study of Palonosetron Versus Dexamethasone in Preventing Postoperative Nausea and Vomiting Following Ear and Nose Surgeries under General Anesthesia
Published: November 1, 2018 | DOI: https://doi.org/10.7860/JCDR/2018/35379.12265
Anju Annie Paul, Sagiev Koshy George, RVRV Ranjan, Mary Kurien, Athmanathan Mohan, Leenu Grace Ninan, Vinu Mervick Alfred
1. Senior Resisdent, Department of Anesthesia, Pondicherry Institute of Medical Sciences, Pondicherry, India.
2. Professor and Head, Department of Anesthesia, Pondicherry Institute of Sciences, Pondicherry, India.
3. Professor, Department of Anesthesia, Pondicherry Institute of Sciences, Pondicherry, India.
4. Professor and Head, Department of ENT, Pondicherry Institute of Sciences, Pondicherry, India.
5. Senior Resisdent, Department of Anesthesia, Pondicherry Institute of Medical Sciences, Pondicherry, India.
6. Senior Resisdent, Department of Anesthesia, Pondicherry Institute of Medical Sciences, Pondicherry, India.
7. Senior Resisdent, Department of Anesthesia, Pondicherry Institute of Medical Sciences, Pondicherry, India.
Correspondence
Dr. Anju Annie Paul,
Department of Anesthesia, Pondicherry Institute of Medical Sciences, Ganapathichettikulam, Kalapet, Pondicherry-605014, India.
E-mail: anjuannie12@gmail.com
Introduction: Postoperative Nausea and Vomiting (PONV) is defined as any nausea or vomiting that occurs during the first 48 hours after surgery. It is considered as a distressing event following anaesthesia. The incidences of PONV is 25-30% in all post-surgical patients and the incidence of PONV with middle ear surgeries are 50%-80%. Various pharmacological techniques were used to prevent PONV. Five-HT3 receptor antagonists are most commonly used prophylactic agents.
Aim: To compare the efficacy and safety of intravenous Palonosetron 75 mcg, and intravenous Dexamethasone 8 mg in preventing PONV.
Materials and Methods: Hundred patients of 18-60 years undergoing ear and nose surgeries under general anaesthesia requiring intubation for more than one hour were randomised into two groups of 50 patients each. Group P received 75mcg of palonosetron and Group D received 8 mg of dexamethasone before induction. The incidence of PONV in the two groups was noted using a four point score until 24 hours postoperatively.
Results: The overall incidence of PONV in 0-24 hours were maximum in the dexamethasone group with 50% and 20% in palonosetron group. The four point score was higher in dexamethasone group compared to palonosetron group & with statistically significant difference. The requirement of rescue antiemetic medication was 30% in dexamethasone group and 10% in palonosetron group.
Conclusion: Our study has shown that palonosetron is more effective in the prevention of PONV without apparent side effects.
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