Reappraisal of the role of dolasetron in prevention and treatment of nausea and vomiting associated with surgery or chemotherapy

Roberts, S. Michael; Bezinover, Dmitri; Janicki, Piotr K.

doi:10.2147/cmar.s15545

Cited by 6 publications

(5 citation statements)

References 39 publications

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“…Serotonin is an ubiquitous central and peripheral neurotransmitter thought to be the predominant mediator of the perception of nausea and triggering of the vomiting response ( 18 ). This occurs in both the brain and the periphery via the serotonin 5-hydroxytryptamine type 3 [5-HT(3)] receptor pathways ( 19 ). Palonosetron, compared to older 5-HT3 receptor antagonist, such as ondansetron, granisetron, dolasetron, and ramosetron, has higher receptor binding affinity and longer plasma half-life (40 h) ( 3 , 6 – 8 , 13 , 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

The Effect of a Combination Treatment Using Palonosetron, Promethazine, and Dexamethasone on the Prophylaxis of Postoperative Nausea and Vomiting and QTc Interval Duration in Patients Undergoing Craniotomy under General Anesthesia: A Pilot Study

et al. 2016

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IntroductionPostoperative nausea and vomiting (PONV) is a displeasing experience that distresses surgical patients during the first 24 h after a surgical procedure. The incidence of postoperative nausea occurs in about 50%, the incidence of postoperative vomiting is about 30%, and in high-risk patients, the PONV rate could be as high as 80%. Therefore, the study design of this single arm, non-randomized, pilot study assessed the efficacy and safety profile of a triple therapy combination with palonosetron, dexamethasone, and promethazine to prevent PONV in patients undergoing craniotomies under general anesthesia.MethodsThe research protocol was approved by the institutional review board and 40 subjects were provided written informed consent. At induction of anesthesia, a triple therapy of palonosetron 0.075 mg IV, dexamethasone 10 mg IV, and promethazine 25 mg IV was given as PONV prophylaxis. After surgery, subjects were transferred to the surgical intensive care unit or post anesthesia care unit as clinically indicated. Ondansetron 4 mg IV was administered as primary rescue medication to subjects with PONV symptoms. PONV was assessed and collected every 24 h for 5 days via direct interview and/or medical charts review.ResultsThe overall incidence of PONV during the first 24 h after surgery was 30% (n = 12). The incidence of nausea and emesis 24 h after surgery was 30% (n = 12) and 7.5% (n = 3), respectively. The mean time to first emetic episode, first rescue, and first significant nausea was 31.3 (±33.6), 15.1 (±25.8), and 21.1 (±25.4) hours, respectively. The overall incidence of nausea and vomiting after 24–120 h period after surgery was 30% (n = 12). The percentage of subjects without emesis episodes over 24–120 h postoperatively was 70% (n = 28). No subjects presented a prolonged QTc interval ≥500 ms before and/or after surgery.ConclusionOur data demonstrated that this triple therapy regimen may be an adequate alternative regimen for the treatment of PONV in patients undergoing neurological surgery under general anesthesia. More studies with a control group should be performed to demonstrate the efficacy of this regimen and that palonosetron is a low risk for QTc prolongation.ClinicalTrials.gov IdentifierNCT02635828 ().

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Section: Introductionmentioning

confidence: 99%

The Effect of a Combination Treatment Using Palonosetron, Promethazine, and Dexamethasone on the Prophylaxis of Postoperative Nausea and Vomiting and QTc Interval Duration in Patients Undergoing Craniotomy under General Anesthesia: A Pilot Study

et al. 2016

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“…Clinical research shows that postoperative nausea and vomiting (PONV) is primarily caused by the use of inhalational anesthesia and opioid analgesics [6]. Studies have shown that the incidence of PONV is reduced by the use of antiemetic drugs such as 5-HT3 receptor antagonists (e.g., dolasetron) and/or total intravenous anesthesia [7–9]. However, despite impressive advances in the field of anesthesia, PONV remains an unpleasant postoperative experience that must be considered.…”

Section: Introductionmentioning

confidence: 99%

Multimodal analgesia with ropivacaine wound infiltration and intravenous flurbiprofen axetil provides enhanced analgesic effects after radical thyroidectomy: a randomized controlled trial

Yang

et al. 2019

BMC Anesthesiol

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Background Thyroidectomy is a common procedure that causes mild trauma. Nevertheless, postoperative pain remains a major challenge in patient care. Multimodal analgesia comprising a combination of analgesics and analgesic techniques has become increasingly popular for the control of postoperative pain. The present study tested the hypothesis that multimodal analgesia with combined ropivacaine wound infiltration and intravenous flurbiprofen axetil after radical thyroidectomy provided better analgesia than a single dosage of tramadol. Methods This randomized controlled trial was conducted in a tertiary hospital. Forty-four patients (age, 18–75 years; American Society of Anesthesiologists status I or II; BMI < 32 kg/m 2 ) scheduled for radical thyroidectomy were randomly assigned to a multimodal analgesia group (Group M) or a control group (Group C) by random numbers assignments, and 40 patients completed the study. All participants and the nurse in charge of follow-up observations were blinded to group assignment. Anesthesia was induced with sufentanil, propofol, and cisatracurium. After tracheal intubation, Group M received pre-incision wound infiltration with 5 ml of 0.5% ropivacaine mixed with epinephrine at 1:200,000 (5 μg/ml); Group C received no wound infiltration. Anesthesia was maintained with target-controlled infusion of propofol, remifentanil, sevoflurane, and intermittent cisatracurium. Twenty minutes before the end of surgery, Group M received 100 mg flurbiprofen axetil while Group C received 100 mg tramadol. Postoperative pain was evaluated with the numerical rating scale (NRS) pain score. Remifentanil consumption, heart rate, and noninvasive blood pressure were recorded intraoperatively. Adverse events were documented. The primary outcome was analgesic effect according to NRS scores. Results NRS scores at rest were significantly lower in Group M than in Group C before discharge from the postoperative anesthetic care unit ( P = 0.003) and at 2 ( P = 0.008), 4 ( P = 0.020), and 8 h ( P = 0.016) postoperatively. Group M also had significantly lower NRS scores during coughing/swallowing at 5 min after extubation ( P = 0.017), before discharge from the postoperative anesthetic care unit ( P = 0.001), and at 2 ( P = 0.002) and 4 h ( P = 0.013) postoperatively. Compared with Group C, NRS scores were significantly lower throughout the first 24 h postoperatively in Group M at rest ( P = 0.008) and during coughing/swallowing ( P = 0.003). No serious adverse events were observed in either group. Conclusion Multimodal analgesia with ropivacaine wound infiltration and intravenous flurbiprofen axetil provided better ana...

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“… 30 In our study Midazolam was commonly utilized drugs similar to finding Sheen MJ, et al 31 study whereas these findings differ from the studies of Patil A, 32 Biswas P, et al 30 where the most commonly used anxiolytic was alprazolam. Here the glycopyrrolate 352 (88%) has been utilized which were more potent than atropine, used routinely as a pre-medication purpose and have less risk to the cardiovascular system, better control of oropharyngeal secretions during reversal stage 8 when compared to Zeev N and Mirakur RK, et al where atropine was the most commonly used. 33 , 34 Another most important drugs utilized in our study as a pre-anesthetic medication was Ondansetron (69.0%) from antiemetic drugs.…”

Section: Discussionmentioning

confidence: 99%

“…7 To minimized the PONV several new drugs have been introduced but the incidence rate remains significantly high, ranging from 30%-35%. 8 So to reduce it or to improve and for better prophylaxis combinations of drugs are used. 9 — 14 …”

Section: Introductionmentioning

confidence: 99%

Utilization of Pre-Anesthetic Medications for Major Surgical Procedures at a Tertiary Care Center: A Descriptive Cross-sectional Study

Shah

Pradhan

Shah³

2020

J Nepal Med Assoc

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Introduction: Drug utilization research is an important tool to analyze the use of drugs with specialemphasis on medical, social, and economic consequences in society. This study aims to find out theutilization of pre-anesthetic medications in a major surgical procedure. Methods: A descriptive cross-sectional study was conducted from 15th April - 15th August 2019 inthe postoperative ward at Birat Medical College and Teaching Hospital. The convenience samplingmethod was used after ethical clearance from the Institutional Review Committee (IRC) of BiratMedical College and Teaching Hospital, Biratnagar, Nepal. About 400 patients were studied.The collected data were entered into a statistical package for social science version 20 for furthercalculations at 95% Confidence Interval. Results: Out of 400 patients, 215 (53.8%) of patients were underwent into different major surgeries.All patients received midazolam 2 mg except children (1 mg) and Pethidine 25 mg along with 0.2 mgglycopyrrolate 352 (88%), ondansetron 276 (69%) and others 58 (14.5%) as a preanesthetic agent. Forgeneral anesthesia propofol, 30 mg have been utilized followed by fentanyl 306 (76.5%) and others(halothane, isoflurane, etc) 115 (28.8%). In case of prophylactic drug were ceftriaxone 500 mg, 100 mgmetoclopramide 387 (96.8%), dexamethasone 251 (62.8%), tramadol 237 (59.3%), 15 mg ketorolac 368(92%), ranitidine 163 (40.8%), and pantoprazole 237 (59.3%). Conclusions: The most commonly administered pre-anesthetic drugs were midazolam, pethidine,glycopyrrolate, and ondansetron. The incidence of postoperative nausea and vomiting the patientwithin 24 hours after surgery was significantly very low.

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Reappraisal of the role of dolasetron in prevention and treatment of nausea and vomiting associated with surgery or chemotherapy

Cited by 6 publications

References 39 publications

The Effect of a Combination Treatment Using Palonosetron, Promethazine, and Dexamethasone on the Prophylaxis of Postoperative Nausea and Vomiting and QTc Interval Duration in Patients Undergoing Craniotomy under General Anesthesia: A Pilot Study

The Effect of a Combination Treatment Using Palonosetron, Promethazine, and Dexamethasone on the Prophylaxis of Postoperative Nausea and Vomiting and QTc Interval Duration in Patients Undergoing Craniotomy under General Anesthesia: A Pilot Study

Multimodal analgesia with ropivacaine wound infiltration and intravenous flurbiprofen axetil provides enhanced analgesic effects after radical thyroidectomy: a randomized controlled trial

Utilization of Pre-Anesthetic Medications for Major Surgical Procedures at a Tertiary Care Center: A Descriptive Cross-sectional Study

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