Postoperative Nausea and Vomiting - A Comparative Study between Palonosetron Vs. Ondansetron in Laparoscopic Cholecystectomies in a Tertiary Health Care Set Up

Abstract

BACKGROUND Postoperative nausea and vomiting (PONV) are the most common complication seen following laparoscopic surgeries. We have conducted a study between two 5 HT3 antagonist palonosetron and ondansetron in patients undergoing laparoscopic cholecystectomies. METHODS A total of 180 patients, aged between 25–55 years, posted for elective laparoscopic cholecystectomies under general anaesthesia belonging to the American Society of Anesthesiologist (ASA), divided into one of two groups (n=90), ASA- I & II were included in the study. Before induction, patients in the first group (Group I) received 0.075 mg palonosetron and patients in the second group (Group II) received 8 mg ondansetron. Postoperatively, any incidences of early or delayed vomiting, requirement of rescue antiemetic, and side effects were recorded. Patient’s hemodynamics were also monitored. Statistical analysis was done using Student’s ttest, chi-square test, and Fisher’s exact test. RESULTS Preoperative, intraoperative, and postoperative heart rate, mean arterial pressure, peripheral capillary oxygen saturation was statistically not significant (p>0.050) in either group. In Group II, 16 patients had nausea in the first two hours and 6 patients had nausea in the two to six-hour postoperative period. In Group I, 6 patients experienced nausea in the first six hours period. 16 patients in Group II had vomited in the first two-hour period compared to 2 patients in Group I (p=0.013). The requirement of rescue antiemetic was greater in Group II than Group I (20% vs. 4%). No side effects were observed. CONCLUSIONS Palonosetron is more effective in treating PONV compared to ondansetron in patients undergoing elective laparoscopic cholecystectomies under general anaesthesia. KEY WORDS Postoperative Nausea and Vomiting, Palonosetron, Ondansetron, Laparoscopic Cholecystectomies.