Comparative study of efficacy of combination of palonosetron hydrochloride & dexamethasone sodium phosphate versus dexamethasone sodium phosphate alone for postoperative nausea & vomiting after modified radical mastectomy

Post-operative nausea & vomiting is a common and distressing complaint observed after Modified Radical Mastectomy surgery performed under General Anaesthesia.

We compare the effect of combined palonosetron (0.075 mg) & dexamethasone (8mg) versus dexamethasone(8mg) administered i.v. alone for controlling post-operative nausea & vomiting in MRM Patients by means of a Randomized double blind control study.

In a prospective randomized study 50 patients of ASA I and ASA II undergoing elective Modified Radical Mastectomy under general anaesthesia were allocated in two groups(25 patients in each).

Group A (Dexona Group) received 8 mg dexona before induction of anaesthesia.

Group B (Palonosetron +dexona Group) received IV DEX 8mg+Palonosetron 0.075 mg before induction of anaesthesia The incidence of PONV, need for rescue antiemetics and complete response was recorded at the end of 0, 2, 4, 6 hr, 12 hrs, 24 hrs.

The incidence of complete response (no PONV, no rescue medication) was 88% (p=0.025) for the early post-operative period (0–6 h) in the combination P+D group and 84% (p=0.032)for the late (6–24 hr) period as compared to 56% and 52% in the dexona only group in the early (0-6h) and the late (6-24h) post-operative period respectively.

Palonosetron-DEX combined regimen given before anaesthesia induction is an effective regimen for early (0–6 hr) and late (6–24 hr) PONV with significantly lower incidence of PONV, higher incidence of complete response and better patient satisfaction.