Ondansetron and palanosetron for prevention of post-operative nausea and vomiting in laparoscopic cholecystectomy: a comparative study

Introduction: The incidence of post-operative nausea and vomiting remains unacceptably high in the
first 24 hours without active intervention following laparoscopic cholecystectomy. Post-operative
nausea and vomiting like postoperative pain, is a complication that delays recovery, prolongs hospital
stays, and increases costs due to additional drug use. The quest for more effective antiemetic drug
without sedative or extrapyramidal side effects has led to the recent development of relatively new
class of drugs such as Ondansetron and Palanosetron.
Aim: To compare the antiemetic effects of Ondansetron and Palonosetron for prevention of postoperative nausea and vomiting in laparoscopic cholecystectomy.
Material and Methods : In all 100 patients aged 18 to 60 years scheduled for laparoscopic
cholecystectomy in Poona Hospital & Research Centre, Pune between December 2014 and November
2015 under general anaesthesia and ready to participate in this prospective, observational double blind
randomized study were included. They were randomly divided into two equal groups of 50 each,
using computer generated randomization code. Group O patients received 4 mg Ondansetron whereas
Group P patients received 0.075 mg Palonosetron. Episodes of post operative nausea & vomiting were
determined and recorded after operation at different time intervals. Patients’ satisfaction grades were
recorded. The comparison of quantitative variables was done using unpaired student’s “t” test,
whereas comparison of qualitative variables was done by using chi-square test or Fisher’s exact test.
Results: Incidence of nausea and vomiting was significantly higher in Ondansetron Group compared
to Palonosetron Group during 0 to 6 hours. Incidence of nausea and vomiting did not differ
significantly between two groups at 6 to 24 hours and 24 to 72 hours.
Conclusions: Palonosetron is an effective antiemetic than Ondansetron in early post operative period.