Intravenous Ondansetron versus Palonosetron for Prevention of Post-Operative Nausea-Vomiting in Middle Ear Surgery under General Anaesthesia

Introduction: Postoperative nausea and vomiting (PONV) is the most common (25-30%) unpleasant and exhausting complication that causes delayed recovery, prolonged hospital admission and increased treatment cost. The incidence of PONV is up to 80% in middle ear surgeries under general anesthesia. The aim of this study was to evaluate the efficacy of intravenous Ondansetron and Palonosetron in the prevention of PONV in middle ear surgeries under general anesthesia.

Method: Total 100 young patients who underwent middle ear surgery under general anesthesia who received i.v. either Ondansetron 8.0 mg or Palonosetron 0.075 mg before induction were taken and divided into two groups (n=40) Group O & Group P, respectively. Data of 80 patients were analysed Incidence of complete response to the drug, post-operative nausea, and vomiting, mean PONV score, use of rescue medication and adverse effects were assessed at the intervals of first 4 h, 4-12 h, 12-24 h and 24-72 h postoperatively. Intravenous metoclopramide was used as the rescue antiemetic.

Results: In initial 4 h, complete response to the drugs, incidences of nausea, vomiting, use of rescue medication and adverse events were found insignificant (p>0.05). These parameters were found higher in group O in later time intervals.

Conclusion: Ondansetron and Palonosetron both are equally effective in the prevention of PONV in initial period but Palonosetron has added effectiveness in the late postoperative period.

Author(s): Pratibha Jain Shah, Rashmi Thakur and Hemendra Kumar Sahu

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