Randomised Control Study of Palonosetron Versus Dexamethasone in Preventing Postoperative Nausea and Vomiting Following Ear and Nose Surgeries under General Anesthesia

Abstract

Introduction: Postoperative Nausea and Vomiting (PONV) is defined as any nausea or vomiting that occurs during the first 48 hours after surgery. It is considered as a distressing event following anaesthesia. The incidences of PONV is 25-30% in all post-surgical patients and the incidence of PONV with middle ear surgeries are 50%-80%. Various pharmacological techniques were used to prevent PONV. Five-HT3 receptor antagonists are most commonly used prophylactic agents. Aim: To compare the efficacy and safety of intravenous Palonosetron 75 mcg, and intravenous Dexamethasone 8 mg in preventing PONV. Materials and Methods: Hundred patients of 18-60 years undergoing ear and nose surgeries under general anaesthesia requiring intubation for more than one hour were randomised into two groups of 50 patients each. Group P received 75mcg of palonosetron and Group D received 8 mg of dexamethasone before induction. The incidence of PONV in the two groups was noted using a four point score until 24 hours postoperatively. Results: The overall incidence of PONV in 0-24 hours were maximum in the dexamethasone group with 50% and 20% in palonosetron group. The four point score was higher in dexamethasone group compared to palonosetron group & with statistically significant difference. The requirement of rescue antiemetic medication was 30% in dexamethasone group and 10% in palonosetron group. Conclusion: Our study has shown that palonosetron is more effective in the prevention of PONV without apparent side effects.

Keywords

• adverse events
• four point scale
• rescue medication