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

Gugale, Amrita Anil; Bhalerao, Pradnya M

doi:10.4103/0259-1162.191121

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…These results are consistent with a study by Amrita et al, which highlighted the high efficacy of palonosetron specifically in the 24-72 h postoperative period. 7 In the study, none of the patients in the combination group required additional anti-emetics, whereas 17.8% of patients in the palonosetron group required rescue anti-emetics, particularly at 6 h after surgery. Comparing these results with the literature review, it appears that the collection of data regarding the requirement for rescue anti-emetics was limited in most studies [8][9][10] , including those comparing palonosetron with a combination of palonosetron and dexamethasone.…”

Section: Discussionmentioning

confidence: 78%

“…The requirement for rescue anti-emetics was also lower in the palonosetron group during the 24-72 h postoperative period (20% versus 56.66%; P < 0.05). 7 The use of acupressure at the P6 point has gained interest in the prevention of PONV due to its ease of application and absence of significant drug-related side effects. Several studies have demonstrated the efficacy of acupressure at the P6 point in preventing PONV.…”

Section: Introductionmentioning

confidence: 99%

“…10 From a Western scientific perspective, it is postulated that acupressure at the P6 point may stimulate the release of endogenous opioids such as beta-endorphins, modulate inhibitory neurotransmitters like norepinephrine or serotonin, and influence the hypothalamic limbic system, thereby exerting analgesic and antiemetic effects. [10][11] Although palonosetron has been proven to be superior to acupressure, dexamethasone, and ondansetron when used individually [6][7]12 , its cost-effectiveness may be a consideration since it is more expensive than other agents. Additionally, combination therapy has shown to be more effective than monotherapy in preventing PONV.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the efficacy of acupressure on P6 point, dexamethasone and ondansetron versus palonosetron monotherapy for preventing postoperative nausea and vomiting in laparoscopic surgery

Zhong,

Mokhtar,

Nik Mohammad

et al. 2023

Anaesth. pain intensive care

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Background: Postoperative nausea and vomiting (PONV) is a common occurrence, affecting approximately 70-80% of patients who have undergone surgery, particularly those with multiple risk factors. The aim of our study was to compare the effectiveness of palonosetron as monotherapy versus a combination of ondansetron with dexamethasone and acupressure P6 wristband in preventing PONV and reducing the need for rescue anti-emetics after laparoscopic surgery. Methodology: A randomized controlled trial involving a total of 90 ASA I and II patients with APFEL scores ≥ 2 was conducted. These patients were recruited and randomly assigned to either the monotherapy or the combination therapy group. In the monotherapy group, patients received intravenous (IV) palonosetron 0.075 mg immediately after induction of anesthesia. In the combination therapy group, patients received dexamethasone 8 mg IV and an acupressure P6 wristband immediately after induction. Subsequently, ondansetron 4 mg IV was administered, and the wristband was removed prior to emergence from anesthesia. For both groups, metoclopramide 10 mg IV was available as a rescue anti-emetic if needed. The frequency of PONV and the requirement of rescue anti-emetics were recorded at multiple time points: at 0, 6, 12, 24, and 48 h postoperatively. Results: In the combination therapy group, 13.3% of patients experienced PONV, compared to 33.3% in the palonosetron group. The difference was statistically significant (95% CI 0.107-0.888, P = 0.025). The combination therapy group had a lower incidence of nausea compared to the palonosetron group, particularly at 6 h (2.2% vs 24.4%, 95% CI 0.009-0.571, P = 0.002) and at 12 h (0% vs 11.1%, 95% CI 1.696-2.662, P = 0.021). The incidence of vomiting was significantly lower in the combination therapy group at 6 h (2.2% vs 15.6%, 95% CI 0.015-1.048, P = 0.026). None of the patients in the combination therapy group required rescue anti-emetics, while 17.8% of patients in the palonosetron group requested these post-operatively. The difference was statistically significant (95% CI 1.746-2.814, P = 0.003). Conclusion: The combination therapy with ondansetron, dexamethasone and acupressure P6 wristband significantly reduced the incidence of PONV and the need for rescue anti-emetics when compared with the palonosetron alone. The benefits of the combination therapy were particularly notable at 6 and 12 h postoperatively, as evidenced by the significantly lower incidence of nausea and vomiting during these time periods. Key words: Combination Therapy; Monotherapy; Palonosetron; PONV; Rescue Anti-Emetics Citation: Zhong CW, Mokhtar AM, Nik Mohammad NA, Omar M, Azmi NM, Mazlan MZ. Comparison of the efficacy of acupressure on P6 point, dexamethasone and ondansetron versus palonosetron monotherapy for preventing postoperative nausea and vomiting in laparoscopic surgery. Anaesth. pain intensive care 2023;27(6):625−631; DOI: 10.35975/apic.v27i6.2148 Received: February 02, 2023; Revised: October 15, 2023; Accepted: November 06, 2023

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Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of the efficacy of acupressure on P6 point, dexamethasone and ondansetron versus palonosetron monotherapy for preventing postoperative nausea and vomiting in laparoscopic surgery

Zhong,

Mokhtar,

Nik Mohammad

et al. 2023

Anaesth. pain intensive care

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show abstract

“…Gugale and Bhalerao[ 33 ] conducted a study using granisetron 0.05 mg/kg and palonosetron 1.5 μg/kg in patients undergoing elective laparoscopic surgery under general anesthesia. In this study, all patients were observed postoperatively for 72 h divided into intervals, i.e.…”

Section: Discussionmentioning

confidence: 99%

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

2018

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Background:In patients undergoing laparoscopic surgeries, postoperative nausea and vomiting (PONV) is a serious concern. With an incidence of 46%–72%, PONV hampers the postoperative recovery in spite of the availability of many antiemetic drugs. The purpose of this study was to prospectively evaluate the efficacy of palonosetron and granisetron for the prevention of PONV in patients undergoing laparoscopic abdominal surgery.Aims:The aim of this study was to evaluate and compare the efficacy of palonosetron and granisetron in preventing PONV and to compare the duration of action and side effects in patients undergoing laparoscopic abdominal surgery under general anesthesia.Settings and Design:Eighty patients who were comparable in all aspects were considered for this study. After their consent, they participated in this prospective, randomized, double-blinded, comparative study.Materials and Methods:In this observational study, 80 patients of either gender who were undergoing laparoscopic abdominal surgery under general anesthesia were enrolled in the study. Based on computer randomization, these patients were divided equally into two groups of 40 patients each in double-blinded manner. The treatments were given intravenously 5 min before induction of anesthesia. The episodes of PONV, severity of nausea/vomiting, and side effects were observed during the first 48 h after surgery.Statistical Tests:At the end of study, results were compiled and SPSS® statistical package version 18.0 (SPSS Inc., Chicago, IL, USA). Two independent samples t-test was used for quantitative data, and Chi-square or Fisher's exact test was used for qualitative data. P < 0.05 was considered significant.Results:The incidence of PONV during 0–2 h in the postoperative period was 15% with palonosetron and 27.5% with granisetron; the incidence during 2–24 h postoperatively was 20% with palonosetron and 30% with granisetron. Both palonosetron and granisetron had comparable effectiveness as antiemetic during the early postoperative periods (0–24 h). During 24–48 h, the incidence was 17.5% and 37.5%, respectively (P = 0.04). Safety profile was similar in both the groups (P = 0.6).Conclusion:There were no significant differences in the overall incidence of PONV and complete responders for palonosetron and granisetron group in the early recovery period. However, due to its prolonged duration of action, palonosetron was more effective than granisetron for long-term prevention of PONV after laparoscopic abdominal surgery.

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Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis

Weibel

Rücker

Eberhart

et al. 2020

Cochrane Database of Systematic Reviews

133

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

Cited by 7 publications

References 16 publications

Comparison of the efficacy of acupressure on P6 point, dexamethasone and ondansetron versus palonosetron monotherapy for preventing postoperative nausea and vomiting in laparoscopic surgery

Comparison of the efficacy of acupressure on P6 point, dexamethasone and ondansetron versus palonosetron monotherapy for preventing postoperative nausea and vomiting in laparoscopic surgery

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

Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis

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