Comparison between palonosetron and ramosetron to prevent postoperative nausea and vomiting in patients undergoing laparoscopic surgery

Postoperative nausea and vomiting (PONV) are very common and distressing adverse events after general anaesthesia. Palonosetron and ramosetron are newer, second generation, selective 5-HT3 receptor antagonists. The present study was carried out to compare the efficacy and safety of palonosetron and ramosetron for prevention of postoperative nausea and vomiting (PONV) over the period of 72 hours in patients undergoing for laparoscopic surgery under general anaesthesia.

80 patients of ASA class I and II undergoing for various laparoscopic surgeries were randomly allocated into 2 groups of 40 each, to receive Inj. palonosetron 75 μg (group P) or Inj. Ramosetron 0.3 mg (group R). Patients were monitored for emesis, severity of nausea, requirement of rescue antiemetic and complete response up to 72 hours (0–6, 6–24, 24–72) post operatively.

During 0–6 hours, severity of PONV was comparable in both drug groups but during 24–72 hours, PONV score 2 was observed in 5% and 17.5% of patients of group P and group R respectively (p=0.027). While score 3 was observed in 15% of patients of group R and none of the patients of group P (p=0.01). On comparison of complete response between Group P and Group R, at 0–6 hours response was almost equal but during 6–24 hours and 24–72 hours number of patient having complete response were more in Group P (97.5% and 82.5%) as compared to Group R (65% and 57% respectively).

Palonosetron given as a prophylaxis for post-operative nausea and vomiting (PONV) in patients undergoing for laparoscopic surgeries seems to have better antiemetic effect over ramosetron.