Study Comparing High Dose Palanosetron 0.075mg with Low Dose Palanosetron 0.05mg Plus 4mg Dexamethasone as Adjuvant for Prevention of Post-Operative Nausea and Vomiting in Laproscopic Hysterectomies - A Double Blinded Study

Prevention of Post-Operative Nausea and Vomiting in Laproscopic Hysterectomies

Abstract

Background: Post op nausea and vomiting is one of the most distressful complications after surgical procedure. The complex of same is very complex but laproscopic surgeries are one of the major reasons. Various agents have been found helpful to deal with this. But keeping in mind the long duration and late showing off of this side effect long acting 5HT3 acting antagonist were invented like palanosetron. But its high cost made its utility less common, so in order to cut down the cost without comprising on effect adjuvants like dexamethasone were used.Aim: To compare 0.075mg palanosetron with 0,05mg palanosetron with 4mg dexamethasone to prevent post op nausea and vomiting in laproscopic surgeries. Subjects and Methods:This study was a  randomised, prospective ,  trial  done on 100 adults, A.S.A. Grade I to II patients, age1865 years going for laparoscopic hysterectomy. They were sent to two groups which got either of the treatment regimens:  Palanosetron 75 microgram (Gr P, number = 50) or dexamethasone four milligram plus palanosetron 50 microgram (Gr PD, number = 50). The main outcome was number of PONV cases in 24 hour and the secondary outcome included number of rescue antiemetic required.  Students t test  used to analyze normally distributed data.  Mann Whitney-U test applied for skewed data.  Chi-square / Fisher exact test whatsoever was applicable was applied to Qualitative /categorical variables. All tests done were two-sided and performed keeping a significance level of 0.05.Results:There was no significant difference in the two groups(P>0.05) in terms of incidence of nausea,vomiting,retching,patient satisfaction and even side effects.Conclusion: 0.05mg palanosetron with 4 mg dexamethasone and 0,075mg Palanosetron are equally effective to prevent post op nausea vomiting plus more cost effective.