Comparison of Intravenous Ondansetron, Ramosetron and Palonosetron for Prevention
of Postoperative Nausea and Vomiting in Patients Undergoing Total Abdominal Hysterectomy: A RCT
UC14-UC17
Correspondence
Dr. Abhinaya Manem,
G5, J-Block, Doctors Quarters, Sduaher, Tamaka, Kolar, Karnataka, India.
E-mail: abhimanem12@gmail.com
Introduction: Postoperative Nausea and Vomiting (PONV) poses a major problem in anaesthetic practice and is associated with various untoward consequences. The 5-hydroxytryptamine Type 3 (5-HT3) receptor antagonists such as ondansetron, ramosetron have been studied and found effective in prevention of PONV. Palonosetron is a newer antiemetic extensively used in chemotherapy patients for prevention of nausea and vomiting.
Aim: To compare the incidence and severity of PONV, when ondansetron, ramosetron and palonosetron were administered as prophylactic antiemetics in gynaecological surgeries.
Materials and Methods: This was a randomised double blind study conducted on 90 women undergoing total abdominal hysterectomy under general anaesthesia. Patients were randomly assigned to three groups to receive intravenously, either ondansetron 8 mg (Group O) or ramosetron 0.3 mg (Group R) or palonosetron 75 µg (Group P), 30 minutes prior to extubation. Incidence and severity of PONV was measured on a Visual Analogue Scale (VAS). A one-way Analysis of Variance (ANOVA) was used to compare continuous variables between the groups.
Results: Incidence of nausea was similar in all the three groups and though not statistically significant, only 2 patients (6.6%) in group P had incidence of nausea at 6 hours after surgery (T6) when compared to 8 (26.6%) in group O. The incidence of vomiting was 9 (30%) in group O compared to 3 (10%) in group P, which was statistically insignificant.
Conclusion: Incidence and severity of PONV is similar in patients who received prophylactic doses of ondansetron, ramosetron and palonosetron, while undergoing abdominal hysterectomy under general anaesthesia.