Abstract
Background
Palonosetron is a 5HT3 receptor antagonist which is used to prevent postoperative nausea and vomiting (PONV).
Design
Prospective Randomized Double Blinded Controlled Clinical Trail.
Patients and methods
A total of 200 female patients of ASA physical status class I and II scheduled for gynecological laparoscopic surgery were randomly allocated into four groups: Control group (group C) received 5 ml saline; Palonosetron group (group P) received 0.075 mg palonosetron; Dexamethasone group (group D) received 8 mg dexamethasone and combined Palonosetron/ Dexamethasone (group P/D) group received a combination of 0.075 palonosetron and 8 mg dexamethasone. Studied drugs were given intravenously(iv) immediately before induction of anaesthesia. Anaesthesia was induced with propofol and fentanyl and maintained with isoflurane/oxygen/air. Diclofenac sodium was given intramuscularly for postoperative analgesia. Metoclopramide was used as rescue antiemetic. Overall incidence, severities of PONV, number of patients who needed rescue antiemetic and side effects of the used drugs were recorded during 1st 24 hours postoperatively.
Results:
The overall incidences, severities of PONV and the number of patients who needed rescue antiemetic in group P, D and P/D were significantly lower than that in group C. Group P and P/D were comparable and significantly lower than that in group D. Side effects of the used drugs were minimal and comparable.
Conclusion:
Palonosetron and combined palonosetron with dexamethasone were comparable and superior to dexamethasone in reducing the incidence and severity of PONV and need to rescue antiemetic in gynecological laparoscopic surgery.
Keywords:
Palonosetron, Dexamethasone, Postoperative nausea and vomiting, laparoscopic surgery.