Comparison of ondansetron, tropisetron, and palonosetron for the prevention of postoperative nausea and vomiting after middle ear surgery

ABSTRACT: Background: Postoperative nausea and vomiting (PONV) are 2 of the most frequent adverse effects of anesthesia. PONV prolongs hospital stays and also delays the recovery of patients. Objective: In this study, the effects of ondansetron, tropisetron, and palonosetron on PONV in patients who...

Full description

Bibliographic Details
Main Authors: Ahmet Aydin, MD, Mustafa Kaçmaz, MD, Adem Boyaci, MD
Format: Article
Language:English
Published: Elsevier 2019-01-01
Series:Current Therapeutic Research
Online Access:http://www.sciencedirect.com/science/article/pii/S0011393X19300104
_version_ 1818390375515029504
author Ahmet Aydin, MD
Mustafa Kaçmaz, MD
Adem Boyaci, MD
author_facet Ahmet Aydin, MD
Mustafa Kaçmaz, MD
Adem Boyaci, MD
author_sort Ahmet Aydin, MD
collection DOAJ
description ABSTRACT: Background: Postoperative nausea and vomiting (PONV) are 2 of the most frequent adverse effects of anesthesia. PONV prolongs hospital stays and also delays the recovery of patients. Objective: In this study, the effects of ondansetron, tropisetron, and palonosetron on PONV in patients who had undergone middle ear surgeries such as mastoidectomy or tympanoplasty were compared. Methods: The study included 165 American Society of Anesthesiologists grade 1 and 2 patients aged 18 to 65 years. Patients were randomized into 3 groups by a closed envelope method. Neither the patients nor the nurses administering the treatments knew which patient belonged to which group. The anesthetic technique was standardized for all groups. During skin closure, 0.075 mg palonosetron, 5 mg tropisetron, and 8 mg ondansetron were administered intravenously to the palonosetron, tropisetron, and ondansetron groups, respectively. After completion of the surgery, the patients were followed for 48 hours. Diclofenac sodium (100 mg IM) was administered to patients experiencing pain and metoclopramide chloride (10 mg IM) was administered to patients with nausea or vomiting. Potential side effects such as headache and constipation were recorded in the postanesthesia care unit and ear, nose, and throat clinic. Results: There was no significant difference in the effects of all 3 antiemetic agents on the severity of PONV (P = 0.081). At 48 hours postoperatively, the incidence of PONV was significantly lower in the palonosteron group (38.2%) than the ondansetron group (63.6%) and tropisetron group (61.8%) (P = 0.011). At 48 hours postoperatively, the incidence of postoperative nausea was significantly lower in the palonosetron group (32.7%) than in the ondansetron group (63.6%) and the tropisetron group (56.4%) (P = .003). The incidence of PONV between hours 12 and 24 postoperatively was significantly higher in the ondansetron group (27.3%) than in the palonosetron group (9.1%) (P = 0.013). The antiemetic requirement in the first hour after surgery was significantly higher in the tropisetron group (25.5%) than in the palonosetron group (7.3%) (P = .019). Conclusions: The results of the current study support those of earlier studies that suggest that palonosetron was statistically more effective than the other 2 formulations in the prevention of PONV in patients who have undergone middle ear surgery. (Curr Ther Res Clin Exp. 2019; 80:XXXXXX). Key words: Ear, Nausea, Ondansetron, Palonosetron, Tropisetron, Vomiting, Classification: sex, age, height, weight, American society of anaesthesiologists score, Postoperative nausea and vomiting scoring system
first_indexed 2024-12-14T04:56:38Z
format Article
id doaj.art-399dc2a63dcb4034bf401f29194001a1
institution Directory Open Access Journal
issn 0011-393X
language English
last_indexed 2024-12-14T04:56:38Z
publishDate 2019-01-01
publisher Elsevier
record_format Article
series Current Therapeutic Research
spelling doaj.art-399dc2a63dcb4034bf401f29194001a12022-12-21T23:16:20ZengElsevierCurrent Therapeutic Research0011-393X2019-01-01911721Comparison of ondansetron, tropisetron, and palonosetron for the prevention of postoperative nausea and vomiting after middle ear surgeryAhmet Aydin, MD0Mustafa Kaçmaz, MD1Adem Boyaci, MD2Department of Anesthesiology, Training and Research Hospital, Niğde, TurkeyDepartment of Anesthesiology, Ömer Halisdemir University Faculty of Medicine, Niğde, Turkey; Address correspondence to: Mustafa Kaçmaz, MD, Ömer Halisdemir Üniversitesi Tıp Fakültesi, Niğde, Türkiye.Department of Anesthesiology, Erciyes University Faculty of Medicine, Kayseri, TurkeyABSTRACT: Background: Postoperative nausea and vomiting (PONV) are 2 of the most frequent adverse effects of anesthesia. PONV prolongs hospital stays and also delays the recovery of patients. Objective: In this study, the effects of ondansetron, tropisetron, and palonosetron on PONV in patients who had undergone middle ear surgeries such as mastoidectomy or tympanoplasty were compared. Methods: The study included 165 American Society of Anesthesiologists grade 1 and 2 patients aged 18 to 65 years. Patients were randomized into 3 groups by a closed envelope method. Neither the patients nor the nurses administering the treatments knew which patient belonged to which group. The anesthetic technique was standardized for all groups. During skin closure, 0.075 mg palonosetron, 5 mg tropisetron, and 8 mg ondansetron were administered intravenously to the palonosetron, tropisetron, and ondansetron groups, respectively. After completion of the surgery, the patients were followed for 48 hours. Diclofenac sodium (100 mg IM) was administered to patients experiencing pain and metoclopramide chloride (10 mg IM) was administered to patients with nausea or vomiting. Potential side effects such as headache and constipation were recorded in the postanesthesia care unit and ear, nose, and throat clinic. Results: There was no significant difference in the effects of all 3 antiemetic agents on the severity of PONV (P = 0.081). At 48 hours postoperatively, the incidence of PONV was significantly lower in the palonosteron group (38.2%) than the ondansetron group (63.6%) and tropisetron group (61.8%) (P = 0.011). At 48 hours postoperatively, the incidence of postoperative nausea was significantly lower in the palonosetron group (32.7%) than in the ondansetron group (63.6%) and the tropisetron group (56.4%) (P = .003). The incidence of PONV between hours 12 and 24 postoperatively was significantly higher in the ondansetron group (27.3%) than in the palonosetron group (9.1%) (P = 0.013). The antiemetic requirement in the first hour after surgery was significantly higher in the tropisetron group (25.5%) than in the palonosetron group (7.3%) (P = .019). Conclusions: The results of the current study support those of earlier studies that suggest that palonosetron was statistically more effective than the other 2 formulations in the prevention of PONV in patients who have undergone middle ear surgery. (Curr Ther Res Clin Exp. 2019; 80:XXXXXX). Key words: Ear, Nausea, Ondansetron, Palonosetron, Tropisetron, Vomiting, Classification: sex, age, height, weight, American society of anaesthesiologists score, Postoperative nausea and vomiting scoring systemhttp://www.sciencedirect.com/science/article/pii/S0011393X19300104
spellingShingle Ahmet Aydin, MD
Mustafa Kaçmaz, MD
Adem Boyaci, MD
Comparison of ondansetron, tropisetron, and palonosetron for the prevention of postoperative nausea and vomiting after middle ear surgery
Current Therapeutic Research
title Comparison of ondansetron, tropisetron, and palonosetron for the prevention of postoperative nausea and vomiting after middle ear surgery
title_full Comparison of ondansetron, tropisetron, and palonosetron for the prevention of postoperative nausea and vomiting after middle ear surgery
title_fullStr Comparison of ondansetron, tropisetron, and palonosetron for the prevention of postoperative nausea and vomiting after middle ear surgery
title_full_unstemmed Comparison of ondansetron, tropisetron, and palonosetron for the prevention of postoperative nausea and vomiting after middle ear surgery
title_short Comparison of ondansetron, tropisetron, and palonosetron for the prevention of postoperative nausea and vomiting after middle ear surgery
title_sort comparison of ondansetron tropisetron and palonosetron for the prevention of postoperative nausea and vomiting after middle ear surgery
url http://www.sciencedirect.com/science/article/pii/S0011393X19300104
work_keys_str_mv AT ahmetaydinmd comparisonofondansetrontropisetronandpalonosetronforthepreventionofpostoperativenauseaandvomitingaftermiddleearsurgery
AT mustafakacmazmd comparisonofondansetrontropisetronandpalonosetronforthepreventionofpostoperativenauseaandvomitingaftermiddleearsurgery
AT ademboyacimd comparisonofondansetrontropisetronandpalonosetronforthepreventionofpostoperativenauseaandvomitingaftermiddleearsurgery