Effects of pretreatment with intravenous palonosetron for propofol-remifentanil-based anesthesia in breast and thyroid cancer surgery: a double-blind, randomized, controlled study

Abstract

BackgroundWe postulated that palonosetron, a novel antiemetic agent, might have the effect of alleviating injection pain from propofol and rocuronium. A double-blind, controlled study was undertaken to evaluate the effect of palonosetron on injection pain during total intravenous anesthesia and postoperative nausea and vomiting (PONV) using propofol-remifentanil in breast and thyroid cancer surgery.MethodsSixty patients were randomly allocated to one of two groups. Before injection of propofol and rocuronium, patients in group S (n = 30) received 4 ml of saline and patients in group P (n = 30) received 75 µg (1.5 ml) of palonosetron mixed with 2.5 ml of saline (n = 30). Patients were evaluated by a blinded anesthesiologist with regard to the scoring of injection pain of propofol, withdrawal response by rocuronium, PONV, shivering, postoperative pain, recall of pain, and overall satisfaction.ResultsThe differences between groups in the incidence of injection pain due to propofol and rocuronium were insignificant. However, in group P, the severity of propofol-induced injection pain (3% vs. 33%, P = 0.003) and postoperative pain (P = 0.038) was significantly lower during the first 12 h after surgery. No differences were observed between the groups with respect to PONV, shivering, recall of pain, and overall satisfaction.ConclusionsWe concluded that pretreatment of palonosetron was effective to reduce the severity of propofol-induced injection pain and early postoperative pain, although it did not reduce the incidence of injection pain from propofol and rocuronium.

Anesthetic effect of propofol combined with remifentanil or sevoflurane anesthesia on patients undergoing radical gastrectomy

“…At present, propofol combined with opiates or propofol combined with inhaled anesthetics are commonly used in patients undergoing radical gastrectomy. Propofol anesthesia has a rapid effect but no analgesic effect, so it needs to be used in combination with other analgesic drugs (5,22). Remifentanil is a short-acting opioid analgesic with rapid onset of anesthesia, good analgesic effect but short duration of action (13).…”

“…Due to environmental pollution, food safety issues, unhealthy lifestyle and other reasons, the incidence of gastric cancer shows a trend of rejuvenation and normality. Most gastric cancer patients receive preoperative chemotherapy, but chemotherapy drugs damage their liver, heart and kidney (5,6). Therefore, gastric cancer patients suffer from large trauma, severe pain and a series of severe stress responses during surgical treatment, as well as more complications after operation (7).…”

Implications of palonosetron in elderly patients undergoing laparoscopic cholecystectomy with respect to its anti-shivering effect

“…Our result is supported by prior clinical studies. Pretreatment of palonosetron 0.075 mg could effectively reduce early postoperative pain after thyroid and breast cancer as well as propofol-induced injection pain [28,29].…”

A comparison of palonosetron and dexamethasone for postoperative nausea and vomiting in orthopedic patients receiving patient-controlled epidural analgesia

“…A previous study reported that the 5-HT 3 receptor is involved in the modulation of nociceptive transmission [ 21 ]. Lee et al [ 22 ] reported that the pain score in the palonosetron group was lower than that of the control group. In addition, in a previous study on the effects of dexamethasone on pain, administration of dexamethasone resulted in reduced pain score, length of hospital stay, and opioid consumption compared with control after total knee arthroplasty [ 23 ].…”