Suman Chattopadhyay1, Sebanti Goswami2. 1. Department of Anaesthesiology, Medical College, Kolkata, 88 College Street, Kolkata, 700073 India ; BC-103, Salt Lake, Kolkata, 700064 India. 2. Department of Obstetrics and Gynaecology, Medical College, Kolkata, 88 College Street, Kolkata, 700073 India.
Abstract
PURPOSE:Postoperative nausea and vomiting (PONV) after spinal anesthesia for cesarean delivery are distressing to both patients and surgeons. This study was designed to evaluate the efficacy and safety of palonosetron and ramosetron (both newer and highly potent 5HT3 receptor antagonists) in nausea and vomiting in cesarean delivery after spinal anesthesia. METHODS: In this randomized, double-blind study, 109 women received eitherpalonosetron (0.075 mg) or ramosetron (0.3 mg) intravenously immediately after clamping of the fetal umbilical cord. Nausea, vomiting, adverse events, and overall satisfaction were then observed for 48 h after administration of spinal anesthesia. RESULTS: A complete response (defined as no postoperative nausea and vomiting) during first 0-2 h postoperative after administration of spinal anesthesia was achieved in 85.5 % of patients with palonosetron and in 83.3 % of patients with ramosetron (p > 0.05). However, the corresponding incidence during 2 to 24 h was 70.9 and 53.7 %, respectively (p < 0.05), while it was 63.3 and 44.4 % at 24-48 h after anesthesia (p < 0.05). Along with a more complete response, the severity of nausea was also lesser with palonosetron during the corresponding study periods (2-24 and 24-48 h, respectively; p < 0.05). Patients who received palonosetron were also more satisfied than those who received ramosetron (p < 0.05). No difference in adverse events was observed in any of the groups. CONCLUSION: To conclude, prophylactic therapy with palonosetron is more effective than prophylactic therapy with ramosetron for the long-term prevention of PONV after cesarean section.
RCT Entities:
PURPOSE:Postoperative nausea and vomiting (PONV) after spinal anesthesia for cesarean delivery are distressing to both patients and surgeons. This study was designed to evaluate the efficacy and safety of palonosetron and ramosetron (both newer and highly potent 5HT3 receptor antagonists) in nausea and vomiting in cesarean delivery after spinal anesthesia. METHODS: In this randomized, double-blind study, 109 women received either palonosetron (0.075 mg) or ramosetron (0.3 mg) intravenously immediately after clamping of the fetal umbilical cord. Nausea, vomiting, adverse events, and overall satisfaction were then observed for 48 h after administration of spinal anesthesia. RESULTS: A complete response (defined as no postoperative nausea and vomiting) during first 0-2 h postoperative after administration of spinal anesthesia was achieved in 85.5 % of patients with palonosetron and in 83.3 % of patients with ramosetron (p > 0.05). However, the corresponding incidence during 2 to 24 h was 70.9 and 53.7 %, respectively (p < 0.05), while it was 63.3 and 44.4 % at 24-48 h after anesthesia (p < 0.05). Along with a more complete response, the severity of nausea was also lesser with palonosetron during the corresponding study periods (2-24 and 24-48 h, respectively; p < 0.05). Patients who received palonosetron were also more satisfied than those who received ramosetron (p < 0.05). No difference in adverse events was observed in any of the groups. CONCLUSION: To conclude, prophylactic therapy with palonosetron is more effective than prophylactic therapy with ramosetron for the long-term prevention of PONV after cesarean section.
Authors: Tong J Gan; Pierre Diemunsch; Ashraf S Habib; Anthony Kovac; Peter Kranke; Tricia A Meyer; Mehernoor Watcha; Frances Chung; Shane Angus; Christian C Apfel; Sergio D Bergese; Keith A Candiotti; Matthew Tv Chan; Peter J Davis; Vallire D Hooper; Sandhya Lagoo-Deenadayalan; Paul Myles; Greg Nezat; Beverly K Philip; Martin R Tramèr Journal: Anesth Analg Date: 2014-01 Impact factor: 5.108
Authors: James D Griffiths; Gillian Ml Gyte; Phil A Popham; Kacey Williams; Shantini Paranjothy; Hannah K Broughton; Heather C Brown; Jane Thomas Journal: Cochrane Database Syst Rev Date: 2021-05-18
Authors: Guilherme Oliveira Campos; Marcelo de Jesus Martins; Gabriel Nascimento Jesus; Paulo Roberto Rios de Oliveira; Caio Nogueira Lessa; João Carlos Macêdo Fernandes de Oliveira Junior; Lucas Jorge Santana de Castro Alves; Rodrigo Leal Alves; Norma Sueli Pinheiro Módolo Journal: BMC Anesthesiol Date: 2019-08-17 Impact factor: 2.217