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Palonosetron in preventing postoperative nausea and vomiting in middle ear surgery: a randomized-controlled study

The Egyptian Journal of Otolaryngology volume 29, pages 156–158 (2013)Cite this article

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Abstract

Background

This study aimed to evaluate the efficacy of palonosetron, the 5-hydroxytryptamine-3 (5-HT3) receptor antagonist, in preventing postoperative nausea and vomiting (PONV) after middle ear surgery.

Patients and methods

Sixty-two ASA I and II patients who had undergone middle ear surgery under general anesthesia were included in a double-blind, placebo-controlled study and were enrolled into two groups: palonosetron group (P) and placebo control group (C). Patients were administered 0.075 mg of palonosetron or isotonic saline, respectively. The incidence of PONV and requirement of rescue antiemetics were assessed. The severity of nausea was evaluated according to the visual analogue scale. Patients who had not experienced any attack of vomiting or received rescue drug were considered to have a complete response.

Results

The incidence of PONV was significantly lower in group P than that in the control group C during (0–4 h) P-value less than 0.001 and (4–24 h) 0.05 periods, and the incidence of complete response was 83.7% in group P and 6.5% in group C (P<0.001).

Conclusion

Palonosetron could provide effective prophylactic antiemetic control to prevent PONV after middle ear surgery under general anesthesia.

References

  1. Honkavaara P. Effect of ondansetron on nausea and vomiting after middle ear surgery during general anaesthesia. Br J Anaesth. 1996;76:316–318.

    Article  CAS  Google Scholar 

  2. Apfel CC, Stoecklein K, Lipfert P. PONV: a problem of inhalational anesthesia? Best Pract Res Clin Anaesthesiol. 2005;19:485–500.

    Article  CAS  Google Scholar 

  3. Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology. 1992;77:162–184.

    Article  CAS  Google Scholar 

  4. Muchatuta NA, Paech MJ. Management of postoperative nausea and vomiting: focus on palonosetron. Ther Clin Risk Manag. 2009;5:21–34.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Miller RC, Galvan M, Gittos MW, van Giersbergen PLM, Moser PC, Fozard JR. Pharmacological properties of dolasetron, a potent and selective antagonist at 5-HT3 receptors. Drug Dev Res. 1993;28:87–93.

    Article  CAS  Google Scholar 

  6. Kovac AL, Eberhart L, Kotarski J, Clerici G, Apfel C. A randomized, double-blind study to evaluate the efficacy and safety of three different doses of palonosetron versus placebo in preventing postoperative nausea and vomiting over a 72- hour period. Anesth Analg. 2008;107:439–444.

    Article  CAS  Google Scholar 

  7. Apfel CC, Roewer N, Korttila K. How to study postoperative nausea and vomiting. Acta Anaesthesiol Scand. 2002;46:921–928.

    Article  CAS  Google Scholar 

  8. Hornby PJ. Central neurocircuitry associated with emesis. Am J Med. 2001;111 (Suppl 8A): 106S–112S.

    Article  Google Scholar 

  9. Jung JS, Park JS, Kim SO, Lim DG, Park SS, Kwak KH, et al.. Prophylactic antiemetic effect of midazolam after middle ear surgery. Otolaryngol Head Neck Surg. 2007;137:753–756.

    Article  Google Scholar 

  10. Lee DW, Lee HG, Jeong CY, Jeong SW, Lee SH. Postoperative nausea and vomiting after mastoidectomy with tympanoplasty: a comparison between TIVA with propofol-remifentanil and balanced anesthesia with sevoflurane-remifentanil. Korean J Anesthesiol. 2011;61:399–404.

    Article  CAS  Google Scholar 

  11. Kovac AL. Prevention and treatment of postoperative nausea and vomiting. Drugs. 2000;59:213–243.

    Article  CAS  Google Scholar 

  12. Camu F, Lauwers MH, Verbessem D. Incidence and aetiology of postoperative nausea and vomiting. Eur J Anaesthesiol. 1992;9 (Suppl 6): 25–31.

    Google Scholar 

  13. Fujii Y, Toyooka H, Tanaka H. Granisetron in the prevention of nausea and vomiting after middle-ear surgery: a dose-ranging study. Br J Anaesth. 1998;80:764–766.

    Article  CAS  Google Scholar 

  14. Bhattacharjee DP, Dawn S, Nayak S, Roy PR, Acharya A, Dey R. A comparative study between palonosetron and granisetron to prevent postoperative nausea and vomiting after laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2010;26:480–483.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Moon YE, Joo J, Kim JE, Lee Y. Anti-emetic effect of ondansetron and palonosetron in thyroidectomy: a prospective, randomized, double-blind study. Br J Anaesth. 2012;108:417–422.

    Article  CAS  Google Scholar 

  16. Fujii Y, Tanaka H, Kobayashi N. Prevention of nausea and vomiting after middle ear surgery: granisetron versus ramosetron. Laryngoscope. 1999;109:1988–1990.

    Article  CAS  Google Scholar 

  17. Oshima T, Kasuya Y, Okumura Y, Terazawa E, Dohi S. Prevention of nausea and vomiting with tandospirone in adults after tympanoplasty. Anesth Analg. 2002;95:1442–1445.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesia, Ain Shams University, Cairo, Egypt, 46266

    Mohamed I. Elahl MD & Michel Badea

Authors
  1. Mohamed I. Elahl MD
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  2. Michel Badea
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Correspondence to Mohamed I. Elahl MD.

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Elahl, M.I., Badea, M. Palonosetron in preventing postoperative nausea and vomiting in middle ear surgery: a randomized-controlled study. Egypt J Otolaryngol 29, 156–158 (2013). https://doi.org/10.7123/01.EJO.0000430965.58638.ee

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  • DOI: https://doi.org/10.7123/01.EJO.0000430965.58638.ee

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