A comparative study of palonosetron and ondansetron in prevention of post operative nausea and vomiting in laparoscopic cholecystectomy surgery

Introduction: In this randomized, double-blind study we evaluated the relative efficacy of palonosetron (a new, selective 5hydroxytryptamine [5-HT3] receptor antagonist) and ondansetron in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy surgery. Materials and Method: Patients were given either palonosetron 0.075 mg (n = 50) or ondansetron 8 mg (n = 50) intravenously, just before anaesthesia. The occurrence of nausea and vomiting and the severity of nausea according to a visual analogue scale were monitored immediately after the end of surgery and during the following 24 hour post surgical period in time intervals of 0-4,4-8,8-12 and 12-24 hour period. Result: The incidence of PONV and nausea (not vomiting) was significantly lower in the palonosetron group than in the ondansetron group during the 24 hour post surgical period (P < 0.05). More patients in the palonosetron group had a complete response (no PONV and no need of rescue antiemetic) compared with the ondansetron group. The need for rescue antiemetics was significantly lower in the palonosetron group than in the ondansetron group during the 24 hour post surgical period (P <0.05). The severity of nausea (VAS) and incidence of adverse effects were not significantly different between the two groups. The incidence of PONV was significantly lower in the palonosetron group compared with the ondansetron group (32% vs 56%, respectively). Conclusion: Palonosetron 0.075 mg was more effective than ondansetron 8 mg in preventing postoperative nausea and vomiting (PONV).