A Prospective Study To Compare Palonosetron Monotherapy with Palonosetron-Dexamethasone Combination for Prevention of PONV in Patients Undergoing Middle Ear Surgery
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 7
Abstract
Introduction: In middle ear surgeries especially mastoidectomy with tympanoplasty, postoperative nausea and vomiting is a major problem and in this modern era with the introduction of newer antiemetics it can be effectively controlled. One such drug introduced in recent times is palonosetron. The aim of this study was to find out whether addition of dexamethasone to palonosetron would be more effective than palonosetron monotherapy in prevention of this problem in patients undergoing middle ear surgery. Material and Methods: The present double blind study was conducted in MLB Medical College, Jhansi. Materials and Methods: Eighty female patients with ASA grade I, II between 18-40 years of age undergoing elective middle ear surgery under general anaesthesia were randomised into two groups of 40 patients each. Group-A received 0.075 mg of palonosetron and Group-B received the same dose of palonosetron and 8 mg of dexamethasone before induction. Induction of anaesthesia was done with propofol and fentanyl while maintained with N2O, oxygen, sevoflurane and muscle relaxant rocuronium. All patients received i.v infusion of inj paracetamol for postoperative analgesia. Metoclopramide/ondansetron was used as rescue antiemetic. The number of patients having PONV were recorded at 0-2, 2-6, 6-24, 24-48 hours post-operatively and requirement of rescue antiemetic in 48 hrs. Chi square test of significance and t-test was used for statistical data assessment with p value of <0.05 considered as statistically significant. Results: The incidence of early PONV in Group A was 75% (n=30) and in Group B 32.5%(n=13) was in was statistically significant (p value<0.001). During 24-48hrs late PONV the incidence in group A was 25% (n=10) and in group B it was 10% (n=4) which was statistically insignificant (p<0.05). Overall use of rescue medication is 37.5% (n=15) in group A and 5% (n=5) in group B (p<0.05). Conclusion: Addition of dexamethasone to palonosetron offers an added advantage over the usage of palonosetron alone in treatment of early PONV.
Authors and Affiliations
Chavi Sethi, Roopesh Kumar, P. Sahi, komal Goel, Dheeraj .
Keywords
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