Anti-emetic effect of ondansetron and palonosetron in thyroidectomy: a
prospective, randomized, double-blind study.
Author(s): Moon YE, Joo J, Kim JE, Lee Y.
Affiliation(s): Department of Anaesthesiology and Pain Medicine, Seoul St Mary' s Hospital,
Catholic University College of Medicine, Seoul, Republic of Korea.
Publication date & source: 2012, Br J Anaesth. , 108(3):417-22
BACKGROUND: Palonosetron is a new potent 5-hydroxytryptamine 3 antagonist.
Although this drug is thought to be more effective in patients receiving
opioid-based patient-controlled analgesia (PCA), clinical data are lacking. This
study compared the effects of i.v. ondansetron and palonosetron administered at
the end of surgery in preventing postoperative nausea and vomiting (PONV) in
high-risk patients receiving i.v. PCA after thyroidectomy.
METHODS: A total of 100 female non-smoking subjects were randomly assigned into a
palonosetron group or an ondansetron group. Ondansetron was given as an 8 mg
bolus and 16 mg was added to the i.v. PCA mixture. In the palonosetron group,
0.075 mg was injected as a bolus only. Fentanyl-based PCA was provided for 24 h
after operation. The incidence of nausea and vomiting, severity of nausea,
requirement for rescue anti-emetics, and adverse effects were evaluated during
0-2 and 2-24 h.
RESULTS: The incidence of PONV during the 24 h postoperative period was lower in
the palonosetron group than in the ondansetron group (42% vs 62%, P=0.045). No
differences were observed between the groups during the first 2 h. However, the
incidence of nausea and vomiting and nausea severity were significantly lower in
the palonosetron group than in the ondansetron group during 2-24 h. The only
difference in the use of rescue anti-emetics was at 2-24 h (10% with palonosetron
compared with 28% with ondansetron, P=0.02).
CONCLUSIONS: Palonosetron is more effective than ondansetron for high-risk
patients receiving fentanyl-based PCA after thyroidectomy, especially 2-24 h
Br J Anaesth. 2012 Jun;108(6):1047-8.