A comparative study of prophylactic ondansetron versus palonosetron for post operative nausea and vomiting in middle ear surgeries

Abstract

Objectives-Postoperative nausea and vomiting (PONV) is a common complication in patients undergone middle ear surgeries under general anaesthesia. The purpose of this study was to compare antiemetic efficacy of prophylactic palonosetron in comparison with ondansetron, administered intravenously in patients undergoing middle ear surgeries under general anaesthesia. Methods-In this prospective, randomized, clinically controlled study 60 ASA grade-I and II patients of either sex, aged between 18 to 50 years, scheduled for middle ear surgery under general anaesthesia were randomly allocated to one of the two groups, group O (n=30), received Inj. ondansetron 8mg I.V., and group P (n=30), received Inj. palonosetron 0.075mg I.V. before induction of anaesthesia. Postoperatively incidence of nausea, vomiting, complete response and need for rescue antiemetics over first 24hrs after surgery were evaluated. Results-The overall incidence of nausea, vomiting once and vomiting more than once, in first 24hrs was higher in ondansetron group than in palonosetron group i.e. 56.66%, 20%, 3.3% and 30%, 3.33%, 0% respectively, and significant statistically (p 0.05). Only 40% patients in group O while 73.3% in group P showed complete response (p=0.009). Number of patients requiring rescue antiemetic were more in group O than group P (p=0.044). Haemodynamically no any major changes were observed in either group. Conclusion-Our study concludes that prophylactic palonosetron 0.075mg IV is more effective than ondansetron 8mg IV for prevention of post operative nausea and vomiting in patients undergoing middle ear surgeries under general anaesthesia.