COMPARISON OF PALONSETRON VS ONDANSETRON FOR PREVENTION OF POST-OPERATIVE NAUSEA AND VOMITING IN LAPAROSCOPIC SURGERIES

Abstract

Postoperative nausea and vomiting (PONV) is one of the most frequent and distressing complications following laparoscopic surgeries. Despite major advances in anesthesia and surgical techniques, the incidence of PONV remains between 20% and 40% in the general population and may reach up to 70% in high-risk patients. Aim: The aim of this study was to compare the efficacy and safety of intravenous palonosetron and ondansetron in preventing postoperative nausea and vomiting in patients undergoing elective laparoscopic surgeries.  Methods: This prospective, randomized, double-blind study included 100 patients aged 18 to 65 years, belonging to ASA physical status I or II, scheduled for elective laparoscopic procedures under general anesthesia. The patients were randomly allocated into two groups of 50 each. Group P received intravenous palonosetron 0.075 mg at induction, while Group O received intravenous ondansetron 8 mg at induction. Standardized anesthesia and surgical protocols were followed for all patients. The incidence of nausea, vomiting, or retching during the first 24 hours postoperatively was recorded. Secondary outcomes included the severity of nausea, the requirement for rescue antiemetic, time to the first episode of nausea or vomiting, hemodynamic stability, and any adverse effects. Results: Out of 100 patients, 50 were assigned to each group. The overall incidence of PONV within 24 hours was 14% in the palonosetron group and 32% in the ondansetron group. The requirement for rescue antiemetic was 8% in Group P and 22% in Group O. The mean time to the first episode of PONV was 15.6 ± 3.2 hours in Group P and 8.9 ± 2.7 hours in Group O. The difference in incidence and time to onset was statistically significant (p < 0.05). No significant difference was noted in hemodynamic parameters or other adverse effects between the two groups. Patient satisfaction scores were higher in the palonosetron group. Conclusion: Palonosetron was found to be more effective than ondansetron in preventing postoperative nausea and vomiting in patients undergoing laparoscopic surgeries. It also delayed the onset of the first episode of PONV and reduced the need for rescue antiemetic medication, with minimal adverse effects. Therefore, palonosetron can be considered a superior and safe alternative to ondansetron for routine prophylaxis of PONV in laparoscopic surgical procedures.