Palonosetron Versus Ondansetron For Post-Operative Nausea And Vomiting During Middle Ear Surgery: A Comparative Observational Study

Abstract

Background: Post-operative nausea and vomiting (PONV), a common morbidity after anesthesia, particularly in middle ear surgeries, has multifactorial etiology. Palonosetron, a newer 5-HT3 receptor antagonist, has been compared with ondansetron for PONV prophylaxis in this study.

Aim: To evaluate the efficacy of palonosetron versus ondansetron in preventing PONV during middle ear surgeries.

Methodology: Sixty ASA I and II patients were divided into two groups of 30 each. Group I received ondansetron (8 mg IV), and Group II received palonosetron (0.075 mg IV). Parameters assessed included nausea and vomiting severity, recovery time, and discharge time.

Results: Palonosetron showed mild early nausea in 10%, moderate in 6%, while ondansetron had mild in 3%, moderate in 7%. Late nausea was mild in 13%, moderate in 4% for palonosetron, and mild in 3%, moderate in 7% for ondansetron. Early vomiting was mild in 7%, moderate in 3% for palonosetron, and mild in 7%, moderate in 10% for ondansetron. Late vomiting was mild in 7%, moderate in 3% for palonosetron, and mild in 10%, moderate in 7% for ondansetron.

Palonosetron was more effective in preventing PONV in the late postoperative stage (4–24 h), while ondansetron was better in the early stage (0–3 h).

Conclusion: Palonosetron is as effective and safe as ondansetron in PONV prevention, with superior efficacy in the late postoperative period.