Comparison of Intravenous Ondansetron, Ramosetron and Palonosetron for Preventionof Postoperative Nausea and Vomiting in Patients Undergoing Total Abdominal Hysterectomy: A RCT

摘要

Postoperative Nausea and Vomiting (PONV) poses a major problem in anaesthetic practice and is associated with various untoward consequences. The 5-hydroxytryptamine Type3 (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 two patients (6.6%) in group P had incidence of nausea at Six hours after surgery (T6) when compared to eight (26.6%) in group O. The incidence of vomiting was nine (30%) in group O compared to three (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.