Palonosetron verses Ondensetron for postoperative nausea in cardiac surgical population- prospective randomized trial
Journal Title: Perspectives In Medical Research - Year 2016, Vol 4, Issue 2
Abstract
Introduction: Postoperative nausea and vomiting (PONV) is distressing complication of anesthesia and surgery. There are very few studies of prevalence of PONV in cardiac surgical population, and in Indian scenario. Aims and Objectives: To study incidence of postoperative nausea and vomiting, in Indian scenario and association of PONV with various factors and efficacy of Palonosetron verses Ondensetron in this prospective randomized control trial. Material and Methods: All patients undergoing open cardiac surgical procedures including off pump, on pump coronary artery bypass grafting, aortic valve replacement, and mitral valve replacement and combined procedures. Patients were aimed at facilitating tracheal extubation within 8–10 h after surgery and discharge from the ICU on postoperative day 3. Patients who had received anti‐emetic medication before surgery were excluded. Preoperative and ICU‐related data were collected. Preoperative variables included age, sex, and obesity, history of diabetes, renal insufficiency and previous PONV and/or motion sickness. ICU‐related data included numbered of episodes of PONV, need for rescue medication, and QTc interval. Patients who developed PONV were randomized by computer generated random number table to receive injection Palonosetron 0.075mg and injection Ondensetron 4 mg intravenous Results: A total of 169 patients were included in the study. Nearly 49% of the patients were above 60 years of age. 34% were females and nearly 50% were diabetic. Previous history of PONV was present in 22% of the cases. Majority of cases included coronary artery bypass grafting and mitral valve replacement which were 47 and 31 % respectively. PONV was documented in 30.76 % of cases. History of PONV, diabetic status, female sex and transesophageal echo use was found to be significantly associated with PONV with p values of 0.0422, 0.0513, 0.002, and 0.0038 respectively. Out of total 52 cases which developed PONV, 30 cases were randomized to receive Palonosetron while 22 received Ondensetron. Complete recovery was observed in 29 cases of Palonosetron while 19 cases of Ondensetron. This difference did not culminate into statistically significant levels with p value of 0.3499 indicating both drugs were similar in efficacy for PONV. Conclusion: Data on PONV in cardiac surgical patients is limited in Indian scenario, the incidence is high and is around 30%. In addition to classic risk factors, transesophageal echo use is another risk factor for PONV. Newer 5HT3 antagonist Palonosetron is equally effecitive for PONV treatment as Ondensetron.
Authors and Affiliations
Nikhil Mudgalkar
Keywords
Related Articles
- EP ID EP306841
- DOI -
- Views 155
- Downloads 0
Prevalence of depression among patients with end stage renal disease
ntroduction:Patients with ESRD are highly susceptible to the psychiatric illnesses of which depression is the most common illness. Depression affects the outcome through its effects on the underlying disease, compliance...
Prevalence and risk factors of depression among elderly population in a rural area
Background: The community-based mental health studies in India have estimated the prevalence of depressive disorders among elderly population between 13% and 25%. Despite of the widespread belief that depression in elder...
Moya Moya disease
Introduction :Moya Moya disease is an entity, which represents chronic idiopathic non-inflammatory progressive occlusion of circle of Willis, which in course of time leads to development of collateral vessels. It is more...
Clinical profile and outcome of Diabetic ketoacidosis in children
Introduction: Diabetic ketoacidosis is a potentially life threatening acute complication of type 1 diabetes mellitus,characterised by triad of hyperglycemia,ketosis and acidemia,accounting for a majority of deaths relate...
Study of relationship between QTC prolongation and cardiac autonomic neuropathy in Diabetes mellitus
Objective: Cardiac Autonomic neuropathy is one of the complications in diabetic patients. This study intends to detect the prevalence of QTc prolongation in diabetic patients as well as its relationship with cardiac auto...