Effect of palonesetron, ondasetron and dexamethasone or dexamethasone for prevention of postoperative nausea and vomiting in videocolecistectomy with total venous anesthesia with propofol-remifentanil - randomized clinical trial
Rationale and objectives: Postoperative nausea and vomiting (PONV) after video cholecystectomy have a high rate. Advances in pharmacological PONV prophylaxis with a new generation of 5-HT3 antagonists have been submitted to examination. This study aims to evaluate the effect of the 5-HT3 antagonist in postanesthetic antiemetic control of video cholecystectomy under total intravenous anesthesia. Method: Sixty individuals who underwent videocolecistectomy were randomized into 3 groups of equal numbers, with 0.125 mg of palonosetron (group 1), or 4 mg of ondansetron and 4 mg of dexamethasone (group 2) or 4 mg of dexamethasone (group 3). The procedure was performed with propofol, remifentanil, and rocuronium. The evaluator of the effect of the drug was unaware of the group to which the participant belonged. PONV was assessed using the Rhodes Scale at 12 and 24 hours after surgery. A dose of 0.655 to 1.5 mg of droperidol was set for rescue therapy. Results: A lower incidence of PONV and the need for rescue therapy during the first hour was observed in Group 1. No significant differences were found between the three groups with regard to the incidence of PONV in the first 12 hours of the postoperative period. The control of PONV in 12 to 24 hours and after the 12-24 hours rescue therapy was higher in groups I and II than in Group 3. Nausea control in the first 12 hours of the postoperative period in Group I was significantly higher than the other methods used. Conclusion: This study showed evidence that palonosetron is superior to other drugs in relation to the prolonged antiemetic effect and lower need of rescue therapy, especially in the ability to completely inhibit the uncomfortable symptoms of nausea.