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

Abstract

Pre-operative administration of palonosetron 0.075 mg did not influence perioperative hypothermia or post-anesthesia shivering in elderly patients undergoing laparoscopic cholecystectomy. However, palonosetron might be beneficial for reducing early postoperative pain in elderly patients with opioid-based patient-controlled analgesia.

5‐HT3 Receptor Antagonists for the Prevention of Perioperative Shivering: A Meta‐Analysis

“…All adult participants in included studies were American Society of Anesthesiologists (ASA) I–II and underwent different kinds of elective operations. Among these trials, 4 studied only female patients whereas 1 tested elderly patients . Patients received neuraxial anesthesia (NA) in 7 studies, 1,26–30,38 spinal anesthesia (SA) in 6 studies, and combined spinal epidural anesthesia (CSEA) in 1 study, whereas patients received general anesthesia (GA) in 9 studies .…”

“…Among these trials, 4 studied only female patients whereas 1 tested elderly patients . Patients received neuraxial anesthesia (NA) in 7 studies, 1,26–30,38 spinal anesthesia (SA) in 6 studies, and combined spinal epidural anesthesia (CSEA) in 1 study, whereas patients received general anesthesia (GA) in 9 studies . Four kinds of 5‐HT 3 RAs were investigated in the 16 trials: 3 studied granisetron, 8 examined ondansetron, 3 investigated ramosetron, and 2 researched palonosetron .…”

“…5‐HT 3 RAs were administered before SA in 3 studies, before CSEA in 1 study, and after SA in 3 trials . Four studies gave the intervention drug prior to induction of GA and 3 after induction of GA . One trial administered the drug 10 minutes before the end of surgery and 1 at the end of surgery .…”

“…Only 4 trials clearly showed the randomized sequence generation method, and 9 studies explicitly demonstrated the allocation concealment method . Five research studies did not clearly report the blinding of participants and personnel, and 3 had no details about the blinding of outcomes assessment . The risk of bias for selective reporting was considered unclear because we could not obtain the published protocol of each trial.…”

“…Six studies carried out their power calculation without specific references . In addition, 7 trials mentioned the source of funding from universities or hospitals without pharmaceutical companies, whereas the other 9 studies did not give the funding information. The summary and strength of evidence for our primary outcome according to GRADE is shown in Table .…”