Comparison of antiemetic activity of palonosetron with granisetron in postoperative nausea and vomiting after laparoscopic gynaecological surgeries
DOI:
https://doi.org/10.18203/2320-6012.ijrms20162599Keywords:
Postoperative nausea and vomiting, Laparoscopic gynaecological surgeries, Granisetron, PalonosetronAbstract
Background: Granisetron is currently one of the commonly used drugs for prevention of postoperative nausea and vomiting (PONV) which is one of the most common distressing complications of laparoscopic surgeries and anesthesia. Palonosetron has emerged as alternative for PONV in adults. Thus, the study was aimed to conduct a comparison of the efficacy and adverse effects of granisetron with palonosetron to prevent PONV in patients undergoing general anaesthesia for elective laparoscopic gynaecological surgeries.
Methods: This was a prospective, randomized, double blinded and a comparative study and was performed in Lokmanya Municipal Medical College and general Hospital, Sion, Mumbai, India on 60 patients undergoing elective laparoscopic gynaecologic surgeries, requiring general anaesthesia with endotracheal intubation.
Results: Both granisetron 2.5 mg and palonosetron 75 µg are comparable in all respects. They have almost similar incidences in nausea, retching, vomiting and administration of rescue antiemetic at 0-2 hrs, 3 hrs, 12 hrs and 24 hrs postoperatively. The values were not significantly different. The adverse effects seen with both the drugs were not statistically significant.
Conclusions: From the study this can be concluded that both the drugs are effective as prophylactic antiemetic in preventing PONV in laparoscopic gynaecological surgeries which are supposed to be highly emetogenic surgery.
References
Sharma ANG, Shankaranarayana P. Postoperative Nausea and Vomiting: Palonosetron with Dexamethasone vs. Ondansetron with Dexamethasone in Laparoscopic Hysterectomies. Oman Med J. 2015;30(4):252-6.
Andrews PLR. Physiology of nausea and vomiting. Br J Anesth. 1992;69 Suppl 1:2-19.
Kovac AL. Prevention and treatment of postoperative nausea and vomiting. Drugs 2000 Feb; 59 (2): 213-43.
Apfel CC, Stoecklein K, Lipfert P. PONV: A problem of inhalational anaesthesia? Best Pract Res Clin Anaesthesiol 2005;19(3):485-500.
Rowbotham DJ. Current management of postoperative nausea and vomiting.Br J Anesth. 1992;69(1):46-59.
Gan TJ. Risk factors for postoperative nausea & vomiting. Anaesthesia Analgesia. 2006;102:1884-98.
Hindle AT. A recent development in the physiology and pharmacology of 5HT3. British Journal of Anaesthesia. 1994;73:397-407.
Yarker E, McTavish D. Granisetron- An update of its therapeutic use in nausea and vomiting produced by antineoplastic therapy. Drugs. 1994;48(5):793.
Granisetron: An update on its clinical use in the management of nausea and vomiting. The Oncologist. 2004;9:673-86.
Stoltz R, Cyong JC, Shah A, Parisi S. Pharmacokinetic and safety evaluation of palonosetron, a 5-hydroxytryptamine-3 receptor antagonist, in U.S. and Japanese healthy subjects. J Clin Pharmacol. 2004;44(5):520-31.
Muchatuta NA, Paech MJ. Management of postoperative nausea and vomiting: focus on palonosetron. Ther Clin Risk Manag. 2009;5:21-34.
Fuji Y, Tanaka H, Toyooka H. Optimal antiemetic dose of granisetron for preventing postoperative nausea and vomiting. Canadian Journal of Anaesthesia. 1994;41(9):794-7.
Mikawa K, Takao Y, Nishina K, Maekawa N, Obara H. The antiemetic efficacy of prophylactic granisetron in gynaecological surgery. Anaesthesia Analgesia. 1995; 80:970-4.
Fuji Y, Tanaka H, Toyooka H. Prophylactic antiemetic therapy with granisetron in women undergoing thyroidectomy. British Journal of Anaesthesia. 1999;81(4):526-8.
Fujii Y, Saitoh Y, Tanaka H, Toyooka H. Comparison of ramosetron and granisetron for preventing postoperative nausea and vomiting after gynecologic surgery. Anesth Analg. 1999;89(2):476-9.
Gralla R, Lichinitser M, Van Der Vegt S, Sleeboom H, Mezger J, et al. Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with ondansetron. Ann Oncol. 2003;14(10):1570-7.
Candiotti KA, Kovac AL, Melson TI, Clerici G, Joo Gan T. Palonosetron 04-06 Study Group,A randomized, double-blind study to evaluate the efficacy and safety of three different doses of palonosetron versus placebo for preventing postoperative nausea and vomiting. Anesth Analg. 2008;107(2):445-51.
Bhattacharjee DP, Dawn S, Nayak S, Roy PR, Acharya A, Dey RA. Comparative study between palonosetron and granisetron to prevent postoperative nausea and vomiting after laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2010;26(4):480-3.
Park SK, Cho EJ. A randomized, double-blind trial of palonosetron compared with ondansetron in preventing postoperative nausea and vomiting after gynaecological laparoscopic surgery. J Int Med Res. 2011;39(2):399-407.
Fuji Y, Tanaka H, Toyooka H. Prevention of postoperative nausea and vomiting with granisetron: a randomized, double-blind comparison with droperidol. Canadian Journal of Anaesthesia. 1995; 42(10):852-6.
Bicer C, Aksu R, Ulgey A, Madenoglu H, Dogan H, Yildiz K, et al. Different doses of palonosetron for the prevention of postoperative nausea and vomiting in children undergoing strabismus surgery. Drugs R D. 2011;11(1):29-36.
Bajwa SS, Bajwa SK, Kaur J, Sharma V, Singh A, Singh A, et al. Palonosetron: A novel approach to control postoperative nausea and vomiting in day care surgery. Saudi J Anaesth. 2011;5(1):19-24.
Gombar S, Kaur J, Kumar Gombar K, Dass A, Singh A. Superior antiemetic efficacy of granisetron plus deexa combination in children undergoing middle ear surgery. Acta Anaesthesiol Scandinavia. 2007;51(5):621-4.
