Gugale Amrita A, Bhalerao Pradnya Milind
Department of Anaesthesiology and Critical Care, B. J. Government Medical College and Sassoon General Hospital, Pune, Maharashtra, India.
Anesth Essays Res. 2016 Sep-Dec;10(3):402-407. doi: 10.4103/0259-1162.191121.
Postoperative nausea and vomiting (PONV) is a common occurrence after laparoscopic surgeries. A number of pharmacological agents (antihistamines, butyrophenones, dopamine receptor antagonists) have been tried of which the 5-hydroxytryptamine type 3 receptor antagonists are devoid of most side effects and highly effective in prevention and treatment of PONV. Thus, we evaluated the effectiveness of granisetron and palonosetron in prevention of PONV after laparoscopic surgeries under general anesthesia.
We conducted a study to evaluate the effectiveness of granisetron and palonosetron, to compare the duration of action and side effects if any, in patients undergoing elective laparoscopic surgery under general anesthesia.
This was a prospective, randomized, double-blinded, comparative study. Sixty patients (18-65 years of age) of the American Society of Anesthesiologists Grade I and II undergoing elective laparoscopic surgeries were considered.
They were randomly allocated into one of the two groups (Group G and Group P) of thirty patients each. Group G received injection granisetron 0.05 mg/kg; Group P received injection palonosetron 1.5 mcg/kg intravenous bolus 30 min before the induction of anesthesia.
All statistical analyses were performed using the SPSS statistical package version 18.0 (Chicago: SPSS Inc). Two independent sample -test was used for quantitative data, and the χ or Fisher's exact test was used for qualitative data. A difference was regarded as statistically significant at a < 0.05.
The need for rescue antiemetic was significantly lower in Group P in the 24-72 h postoperative period (ρ - 0.007). The PONV score was significantly less in Group P in the same period (ρ - 0.008). The incidence of side effects was statistically insignificant in both the groups (ρ - 0.999).
Prophylactic therapy with palonosetron is more effective than granisetron in the prevention of PONV after laparoscopic surgeries under general anesthesia.
术后恶心呕吐（PONV）是腹腔镜手术后的常见情况。已经尝试了多种药物（抗组胺药、丁酰苯类、多巴胺受体拮抗剂），其中5-羟色胺3型受体拮抗剂副作用最少，在预防和治疗PONV方面非常有效。因此，我们评估了格拉司琼和帕洛诺司琼在全身麻醉下腹腔镜手术后预防PONV的有效性。
我们进行了一项研究，以评估格拉司琼和帕洛诺司琼的有效性，比较在全身麻醉下接受择期腹腔镜手术患者的作用持续时间和副作用（如有）。
这是一项前瞻性、随机、双盲、对照研究。纳入60例年龄在18 - 65岁、美国麻醉医师协会分级为I级和II级的择期腹腔镜手术患者。
他们被随机分为两组（G组和P组），每组30例。G组接受0.05 mg/kg格拉司琼注射液；P组在麻醉诱导前30分钟接受1.5 mcg/kg帕洛诺司琼注射液静脉推注。
所有统计分析均使用SPSS统计软件包18.0版（芝加哥：SPSS公司）进行。定量数据采用两独立样本t检验，定性数据采用χ²检验或Fisher精确检验。P < 0.05被认为具有统计学意义。
术后24 - 72小时，P组需要补救性使用止吐药的情况显著低于G组（P = 0.007）。同一时期，P组的PONV评分显著低于G组（P = 0.008）。两组副作用发生率在统计学上无显著差异（P = 0.999）。
在全身麻醉下腹腔镜手术后预防PONV方面，帕洛诺司琼预防性治疗比格拉司琼更有效。
