Effects of palonosetron and ramosetron mixed with intravenous patient-controlled analgesia infusion fluid after preoperative single injection of palonosetron for the prevention of postoperative nausea and vomiting

Objective: To evaluate the effects of the antiemetic drugs palonosetron and ramosetron, mixed with opioid-based intravenous patient controlled analgesia (IV-PCA) regimen on postoperative nausea and vomiting (PONV). Methodology: Patients were randomly allocated to three groups. Palonosetron (0.075 mg) was administered intravenously to all patients before anesthetic induction, and a 100-ml IV-PCA infusion, which contained 20 mcg/kg of fentanyl with placebo (normal saline) in group 1, ramosetron (0.3 mg) in group 2, and palonosetron (0.075 mg) in group 3 was started at the end of surgery. PONV, postoperative pain, and adverse effects were assessed. at PACU was lower in group 2 than in group 1 (5.6% vs 33.3%, p<0.05). Postoperative nausea scores at PACU and 6 h after discharge from PACU were significantly lower in group 2 and group 3 than in group 1. The requirement of rescue antiemetics was higher in group 1 than in other groups (p=0.004). There were no differences in the incidence and severity of PONV between ramosetron and palonosetron groups. Conclusion: Infusion of palonosetron or ramosetron with the IV-PCA regimen may help to prevent PONV effectively. However, there was no difference between the effect of palonosetron and ramosetron. (author)