A. Rathna, R. Shankar Babu, Rama Selvam
BACKGROUND Postoperative Nausea and Vomiting (PONV) is an incessant postoperative complication of surgery associated with patient inconvenience and discomfort and can be an unpleasant experience. We designed this study to assess the antiemetic efficacy of palonosetron versus dexamethasone in the prevention of PONV among patients undergoing laparoscopic surgery under general anaesthesia. MATERIALS AND METHODS This prospective randomised double-blind study was conducted on 106 patients aged between 20 to 60 years of either sex belonging to ASA I and ASA II undergoing laparoscopic surgery under general anaesthesia after obtaining institutional ethical committee clearance and patient’s written informed consent. The patients were randomly divided into two groups- group P (n=53) received palonosetron 0.075 mg IV and group D (n=53) received dexamethasone 8 mg IV five minutes before induction of anaesthesia. All the patients were observed for nausea and emetic episodes after recovery from anaesthesia during periods of 0-6 hours, 6-12 hours and 12-24 hours. RESULTS The demographical profile of the patients in both groups was comparable. In the first 0-6 hour postoperative period, 7 out of 53 patients (13.2%) in group P and 20 out of 53 patients (37.7%) in group D had vomiting. P value was significant (P=0.004). During the 0 to 6 hours postoperative period, the incidence of nausea was 9.4% in group P, whereas in group D, it was 24.5%. P value was significant (P=0.04). During the 6 to 24 hours postoperative period, the incidence of nausea and vomiting was comparable in both groups (P>0.05). In the 0-6 hours postoperative period, the number of complete responders (no vomiting, no rescue antiemetics) was 40/53 (75.5%) in group P and 30/53 (56.6%) in group D and the difference was clinically and statistically significant (P=0.040). In the next 6-12 hours and 12-24 hours postoperative period, the number of complete responders were comparable in both groups. No major adverse effects were seen in both groups due to the study drugs. CONCLUSION Single intravenous dose of palonosetron or dexamethasone given preoperatively prevented the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic surgeries under general anaesthesia without any side effects. Palonosetron was comparatively more effective than dexamethasone in the early postoperative period to prevent the PONV than dexamethasone.
