Different Doses of Palonosetron for the Prevention of Postoperative Nausea and Vomiting in Children Undergoing Strabismus Surgery

Abstract

Objective: The aim of this study was to evaluate the efficacy of different doses of palonosetron for the prevention of PONV in children undergoing strabismus surgery.Patients and Method: A total of 150 children who were classified with an American Society of Anesthesiologists physical status of I, were aged between 2 and 12 years, and were undergoing strabismus surgery under general anesthesia were enrolled in the study. A random numbers table was used to assign each child to receive palonosetron 0.5, 1.0, or 1.5 μg/kg (n = 50 in each group).All episodes of PONVat the intervals of 0–2, 2–6, 6–24, and 24–48 hours were evaluated using a numeric scoring system for PONV. A p-value of <0.05 was considered statistically significant.Results: The percentage of children with PONV during 0–48 hours after anesthesia was 24% with palonosetron 0.5 or 1.0 μg/kg, and 20% with palonosetron 1.5 μg/kg. There was no statistically significant difference between the study groups with respect to the number of children with PONV scores of 1, 2, or 3 during 0–48 hours after anesthesia. There was no statistically significant difference between the study groups with respect to the number of children with postoperative vomiting during all time periods after anesthesia. The percentage of children aged >6 years with postoperative nausea during 0–48 hours after anesthesia was 8.6%, 18.2%, and 15.4% with palonosetron 0.5, 1.0, or 1.5 μg/kg, respectively, but there was no statistically significant difference between the study groups.Conclusion: Palonosetron doses of 0.5, 1.0, and 1.5 μg/kg are recommended for further evaluation, as they appear to be the effective doses for the prevention of PONV following strabismus surgery in children.

A prospective, randomized, double-blind trial to compare body weight-adjusted and fixed doses of palonosetron for preventing postoperative nausea and vomiting in obese female patients

“…The impact of body weight on determining the dose of palonosetron has not yet been investigated; therefore, only obese patients were enrolled. A body weight-adjusted dose of 1 μg kg -1 was proposed based on other dosing schedule studies [12,13]. The latter study [13], in which body weight-adjusted doses of palonosetron of 0.5, 1.0, and 1.5 μg kg -1 were used, enrolled a population with the average weight of 60 kg, resulting in mean doses of 30, 60 and 90 μg, respectively.…”

“…Initially, palonosetron was used to prevent nausea and vomiting induced by chemotherapy [10], but it has also been proven effective for preventing PONV [7,11], usually at a dose of 75 μg. Although a few trials have evaluated body weight-adjusted doses [12,13], the ideal dose for obese patients has not yet been investigated.…”

Comparison of palonosetron with granisetron for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic abdominal surgery

“…This may account for the longer duration of this drug. [ 29 30 ] For the treatment of CINV, the effective dose of granisetron is 40–80 μg/kg). In this study, 2.5 mg was selected as dose of granisetron.…”

Palonosetron and granisetron in postoperative nausea vomiting: A randomized double-blind prospective study

“…Granisetron produces irreversible block of the 5-HT 3 receptors, and it may account for the long duration of this drug. [ 9 10 ] Palonosetron shows avid binding to the 5-HT 3 receptor which far exceeds than the other 5-HT 3 antagonists and has the longest elimination half-life of 40 h. We did not choose a placebo group as a control group in our study because the patients we chose were having a 40% risk of developing PONV and denial of effective antiemetic treatment was unjustified and unethical. Fuji et al .…”