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Masters Thesis | Anaesthesiology | India | Volume 14 Issue 3, March 2025 | Popularity: 5.1 / 10
Comparison of Ramosetron and Palonosetron for Prevention of Post Operative Nausea and Vomiting in Adult Patients Undergoing Middle Ear Surgery Under General Anaesthesia
Dr. Mayank Arora, Dr Mohandeep Kaur
Abstract: Background: Postoperative Nausea and Vomiting (PONV) is one of the most distressing adverse effects following anaesthesia and surgery. High incidence of PONV has been demonstrated after middle ear surgery. 5-Hydroxytryptamine (5-HT3) receptor antagonists are used commonly due to higher efficacy and lesser side effects. Ondansetron is most commonly used for prevention of PONV. Both palonosetron and ramosetron have been reported to be superior to ondansetron for PONV prevention. This study is being undertaken to compare the efficacy of palonosetron and ramosetron for the prevention of PONV in middle ear surgeries. Objectives: Primary Objective: Number of episodes of PONV in 24 hours following conclusion of anaesthesia. Secondary Objectives: 1) Rescue antiemetic, if required 2) Overall satisfaction of patient with nausea and vomiting experience 3) Incidence of adverse effects like headache, dizziness, drowsiness, injection site reaction etc. All the above 3 parameters were observed over 24 hours following conclusion of anaesthesia. Methods: In this Single blinded Randomised Controlled study, 60 adult patients undergoing middle ear surgery were randomised into 2 groups of 30 each to receive Palonostreon or Ramosetron. PONV Score, Rescue Antiemetic requirement, Adverse effects and Overall patient satisfaction were assessed at time of reversal and during the time interval of 0-2 hours, 2-6 hours, 6-12 hours and 12-24 hours after completion of surgery. RESULTS: Both groups were comparable with respect to age, sex, BMI, ASA grade and duration of anaesthesia. Higher incidence of PONV and PONV score was seen at 6 ? 12 hours time-interval with ramosetron. Use of rescue antiemetic was seen only with ramosetron. Overall patient satisfaction was higher with palonosetron. Conclusion: In our study palonosetron was found to be superior to ramosetron for PONV prophylaxis. It has similar safety profile as ramosetron but longer duration of action which can have implications in providing a better and longer duration of prophylaxis.
Keywords: postoperative nausea and vomiting, middle ear surgery, palonosetron, ramosetron, antiemetics
Edition: Volume 14 Issue 3, March 2025
Pages: 210 - 237
DOI: https://www.doi.org/10.21275/SR25303110024
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