Giridharan, S (2016) Compare the efficacy of palonosetron over ondansetron in prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anesthesia. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.
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Abstract
INTRODUCTION: The post operative nausea and vomiting is one of the common complications following anaesthesia. The incidence of post operative nausea and vomiting is more following general anaesthesia than regional anaesthesia. The patients undergoing laparoscopic surgeries are more prone for developing post operative nausea and vomiting. Hence we evaluated the efficacy of the effectiveness of intravenous Palonosetron 75mcg with intravenous Ondansetron 4mg as single pre induction dose in laparoscopic cholecystectomy in preventing PONV following general anaesthesia. METHODOLOGY: After obtaining Institutional Human Ethics Committee clearance the study was carried out in PSGIMS&R during July 2014 – May 2015. A total of 100 patients who were posted for laparoscopic cholecystectomy belonging to ASA Class I & II were included in the study. These patients were randomized into 2 groups of 50 each by computer generated randomized numbers. The patients belonging to Group – A received Inj. Ondansetron 4mg just before induction of anaesthesia and patients belonging to Group – B received Inj. Palonosetron 75mcg just before induction of anaesthesia. All patients were followed for 24 hours post operatively. The incidences of nausea, retching and vomiting were observed postoperatively during 2 hrs, 6 hrs and 24 hrs post procedure interval period. RESULTS: In our study, the incidence of nausea, retching, vomiting at 24 hrs post procedure in Ondansetron group are 38%, 16% and 28% respectively. The incidence of nausea and vomiting at 24 hrs post procedure in Palonosetron group are 12% and 4%. The incidence of nausea and vomiting are more at period between 6hrs and 24 hrs post procedure. The incidence of nausea was 38 percent in Ondansetron group and 12 percent in Palonosetron group [p value 0.003]. The incidence of vomiting was 28 percent in Ondansetron group and 4 percent in Palonosetron group [p value 0.001]. Need for rescue medication was also high in Ondansetron group when compared to Palonosetron group [p value 0.001]. The complete responders in Ondansetron group are 62% and in Palonosetron group are 88% [p value 0.003]. There were no adverse events reported throughout the study in both the groups. CONCLUSION: Based on our study, it is observed that Palonosetron a second generation 5HT3 receptor antagonist has prolonged duration of action and has decreased the incidence of post operative nausea and vomiting significantly when compared to Ondansetron, providing patients with lesser episodes of PONV in patients undergoing laparoscopic cholecystectomy under general anesthesia.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Post operative nausea and vomiting ; Ondansetron ; Palonosetron ; Laparoscopic cholecystectomy. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Punitha K |
| Date Deposited: | 15 Jun 2018 03:31 |
| Last Modified: | 15 Jun 2018 16:35 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8488 |
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