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A Comparative Study of Palonosetron with Ondansetron for Prophylaxis of Postoperative Nausea and Vomiting (PONV) Following Laparoscopic Gynaecological Surgeries

Rohit Balyan
Rohit Balyan
, 
Sachin Kumar
Sachin Kumar
, 
K. Lalitha
K. Lalitha
, 
Sanjeev Aneja
Sanjeev Aneja
 and 
Jai S. George
Jai S. George
   | Jan 14, 2023
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Article Category: Original Paper
Published Online: Jan 14, 2023
Page range: 32 - 40
DOI: https://doi.org/10.2478/rjaic-2022-0005
Keywords
© 2022 Rohit Balyan et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Consort flow diagram.
Consort flow diagram.

Figure 2

Comparison of postoperative overall PONV score between group A [Ondansetron] and group B [Palonosetron]; 0–3 on x-axis denotes PONV scoring system used at various time intervals in postoperative period [Table 1].
Comparison of postoperative overall PONV score between group A [Ondansetron] and group B [Palonosetron]; 0–3 on x-axis denotes PONV scoring system used at various time intervals in postoperative period [Table 1].

Figure 3

Comparison of amount of ondansetron [first line rescue antiemetic drug] used between group A [ondansetron] and group B [palonosetron] [0,1,2,3 on x-axis denotes the number of times rescue antiemetic drug administered during a time interval in post-operativ.
Comparison of amount of ondansetron [first line rescue antiemetic drug] used between group A [ondansetron] and group B [palonosetron] [0,1,2,3 on x-axis denotes the number of times rescue antiemetic drug administered during a time interval in post-operativ.

Patient characteristics and duration of anaesthesia.

Group A [n=65] Group B [n=65] P-value
Age [years] 37.40 ± 9.59 39.51 ± 8.67 0.191
Weight [kg] 64.90 ± 11.10 65.10 ± 8.53 0.909
ASA grade [I/II] 32/33 [49.2%/50.8%] 39/26 [60%/40%] 0.218
Duration of anaesthesia [min] 150.85 ± 57.42 145.08 ± 36.23 0.495
Morphine requirement in PACU [Number of patient/%] 20 [30.76] 16 [24.61] 0.435

Postoperative nausea and vomiting (PONV) score.

Overall PONV score Group A [n=65] Frequency [%] Group B [n=65] Frequency [%] P-value
0–2 h 0 51 [78] 48 [74] 0.218
1 7 [11] 14 [21]
2 2 [3] 0 [0]
3 5 [8] 3 [5]
2–24 h 0 26 [40] 41 [63] 0.023*
1 22 [34] 16 [25]
2 0 [0] 0 [0]
3 17 [26] 8 [12]
24–48 h 0 58 [89] 57 [88] 0.177
1 6 [9] 8 [12]
2 0 [0] 0 [0]
3 1 [2] 0 [0]

Scoring system used for assessing postoperative nausea, vomiting, and PONV.

Score Postoperative nausea score Postoperative vomiting score PONV score
0 None None No nausea /vomiting /retching /no rescue antiemetic required
1 Mild, intermittent nausea One vomit only Nausea
2 Constant, moderate nausea Several vomits Retching
3 Severe nausea Repeated retching/vomiting Vomiting

Postoperative nausea score

Overall nausea score Group A [n=65] Frequency [%] Group B [n=65] Frequency [%] P-value
0–2 h 0 51 [78.4] 50 [77] 0.101
1 7 [10.8] 13 [20]
2 0 [0] 0 [0]
3 7 [10.8] 2 [3]
2–24 h 0 26 [40] 43 [66] 0.010*
1 24 [37] 15 [23]
2 0 [0] 0 [0]
3 15 [23] 7 [11]
24–48 h 0 58 [89] 56 [86] 0.593
1 7 [11] 9 [14]
2 0 [0] 0 [0]
3 0 [0] 0 [0]

Amount of ondansetron [first line rescue antiemetic drug] used.

Amount of ondansetron [no. of doses] Group A [n=65] Frequency [%] Group B [n=65] Frequency [%] P-value
0–2 h 0 51 [79] 50 [77] 0.833
1 14 [21] 15 [23]
2–24 h 0 29 [44] 45 [69] 0.012
1 24 [37] 15 [23]
2 7 [11] 5 [8]
3 5 [8] 0 [0]
24–48 h 0 56 [86] 62 [95] 0.102
1 6 [9] 1 [2]
2 1 [2] 2 [3]
3 2 [3] 0 [0]

Postoperative vomiting score.

Overall vomiting score Group A [n=65] Frequency [%] Group B [n=65] Frequency [%] P-value
0–2 h 0 59 [91] 61 [95] 0.061
1 6 [9] 1 [2]
2 0 [0] 0 [0]
3 0 [0] 2 [3]
2–24 h 0 48 [74] 56 [86] 0.173
1 11 [17] 7 [11]
2 0 [0] 0 [0]
3 6 [9] 2 [3]
24–48 h 0 64 [98.5] 65 [100] 1.000
1 1 [1.5] 0 [0]
2 0 [0] 0 [0]
3 0 [0] 0 [0]

Incidence of adverse events.

Adverse effects Group A Frequency [%] Group B Frequency [%] P-value
Headache 10 [15] 8 [12] 0.800
Dizziness 4 [6] 8 [12] 0.364
Drowsiness 14 [22] 17 [26] 0.537
Constipation 4 [6] 14 [22] 0.020
Allergic reaction 0 [0] 0 [0] -
ECG changes 0 [0] 0 [0]
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