Comparison of Intravenous Ondansetron, Ramosetron and Palonosetron for Prevention
of Postoperative Nausea and Vomiting in Patients Undergoing Total Abdominal Hysterectomy: A RCT
Published: November 1, 2021 | DOI: https://doi.org/10.7860/JCDR/2021/50592.15655
Sumanth Tarigonda, Abhinaya Manem, Kailasanath Udupi Shenoy, Arun Kumar Handigodu Duggappa, Rohith Krishna
1. Assistant Professor, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India.
2. Senior Resident, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India.
3. Professor, Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, India.
4. Associate Professor, Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, India.
5. Associate Professor, Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, India.
Correspondence
Dr. Abhinaya Manem,
G5, J-Block, Doctors Quarters, Sduaher, Tamaka, Kolar, Karnataka, India.
E-mail: abhimanem12@gmail.com
Introduction: Postoperative Nausea and Vomiting (PONV) poses a major problem in anaesthetic practice and is associated with various untoward consequences. The 5-hydroxytryptamine Type 3 (5-HT3) receptor antagonists such as ondansetron, ramosetron have been studied and found effective in prevention of PONV. Palonosetron is a newer antiemetic extensively used in chemotherapy patients for prevention of nausea and vomiting.
Aim: To compare the incidence and severity of PONV, when ondansetron, ramosetron and palonosetron were administered as prophylactic antiemetics in gynaecological surgeries.
Materials and Methods: This was a randomised double blind study conducted on 90 women undergoing total abdominal hysterectomy under general anaesthesia. Patients were randomly assigned to three groups to receive intravenously, either ondansetron 8 mg (Group O) or ramosetron 0.3 mg (Group R) or palonosetron 75 µg (Group P), 30 minutes prior to extubation. Incidence and severity of PONV was measured on a Visual Analogue Scale (VAS). A one-way Analysis of Variance (ANOVA) was used to compare continuous variables between the groups.
Results: Incidence of nausea was similar in all the three groups and though not statistically significant, only 2 patients (6.6%) in group P had incidence of nausea at 6 hours after surgery (T6) when compared to 8 (26.6%) in group O. The incidence of vomiting was 9 (30%) in group O compared to 3 (10%) in group P, which was statistically insignificant.
Conclusion: Incidence and severity of PONV is similar in patients who received prophylactic doses of ondansetron, ramosetron and palonosetron, while undergoing abdominal hysterectomy under general anaesthesia.
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