Aydin Ahmet, Kaçmaz Mustafa, Boyaci Adem
Department of Anesthesiology, Training and Research Hospital, Niğde, Turkey.
Department of Anesthesiology, Ömer Halisdemir University Faculty of Medicine, Niğde, Turkey.
Curr Ther Res Clin Exp. 2019 Jun 22;91:17-21. doi: 10.1016/j.curtheres.2019.06.002. eCollection 2019.
Postoperative nausea and vomiting (PONV) are 2 of the most frequent adverse effects of anesthesia. PONV prolongs hospital stays and also delays the recovery of patients.
In this study, the effects of ondansetron, tropisetron, and palonosetron on PONV in patients who had undergone middle ear surgeries such as mastoidectomy or tympanoplasty were compared.
The study included 165 American Society of Anesthesiologists grade 1 and 2 patients aged 18 to 65 years. Patients were randomized into 3 groups by a closed envelope method. Neither the patients nor the nurses administering the treatments knew which patient belonged to which group. The anesthetic technique was standardized for all groups. During skin closure, 0.075 mg palonosetron, 5 mg tropisetron, and 8 mg ondansetron were administered intravenously to the palonosetron, tropisetron, and ondansetron groups, respectively. After completion of the surgery, the patients were followed for 48 hours. Diclofenac sodium (100 mg IM) was administered to patients experiencing pain and metoclopramide chloride (10 mg IM) was administered to patients with nausea or vomiting. Potential side effects such as headache and constipation were recorded in the postanesthesia care unit and ear, nose, and throat clinic.
There was no significant difference in the effects of all 3 antiemetic agents on the severity of PONV ( = 0.081). At 48 hours postoperatively, the incidence of PONV was significantly lower in the palonosteron group (38.2%) than the ondansetron group (63.6%) and tropisetron group (61.8%) ( = 0.011). At 48 hours postoperatively, the incidence of postoperative nausea was significantly lower in the palonosetron group (32.7%) than in the ondansetron group (63.6%) and the tropisetron group (56.4%) ( = .003). The incidence of PONV between hours 12 and 24 postoperatively was significantly higher in the ondansetron group (27.3%) than in the palonosetron group (9.1%) ( = 0.013). The antiemetic requirement in the first hour after surgery was significantly higher in the tropisetron group (25.5%) than in the palonosetron group (7.3%) ( = .019).
The results of the current study support those of earlier studies that suggest that palonosetron was statistically more effective than the other 2 formulations in the prevention of PONV in patients who have undergone middle ear surgery. ( 2019; 80:XXXXXX).
术后恶心呕吐（PONV）是麻醉最常见的两种不良反应。PONV会延长住院时间，还会延迟患者康复。
本研究比较了昂丹司琼、托烷司琼和帕洛诺司琼对接受乳突切除术或鼓室成形术等中耳手术患者PONV的影响。
该研究纳入了165例年龄在18至65岁之间的美国麻醉医师协会1级和2级患者。采用封闭信封法将患者随机分为3组。患者和给予治疗的护士均不知道哪位患者属于哪一组。所有组的麻醉技术均标准化。在皮肤缝合时，分别向帕洛诺司琼组、托烷司琼组和昂丹司琼组静脉注射0.075mg帕洛诺司琼、5mg托烷司琼和8mg昂丹司琼。手术结束后，对患者进行48小时随访。对疼痛患者给予双氯芬酸钠（100mg肌内注射），对恶心或呕吐患者给予甲氧氯普胺（10mg肌内注射）。在麻醉后护理单元以及耳鼻喉科门诊记录头痛和便秘等潜在副作用。
所有3种止吐药对PONV严重程度的影响无显著差异（=0.081）。术后48小时，帕洛诺司琼组的PONV发生率（38.2%）显著低于昂丹司琼组（63.6%）和托烷司琼组（61.8%）（=0.011）。术后48小时，帕洛诺司琼组的术后恶心发生率（32.7%）显著低于昂丹司琼组（63.6%）和托烷司琼组（56.4%）（=0.003）。术后12至24小时，昂丹司琼组的PONV发生率（27.3%）显著高于帕洛诺司琼组（9.1%）（=0.013）。术后第一小时托烷司琼组的止吐需求（25.5%）显著高于帕洛诺司琼组（7.3%）（=0.019）。
本研究结果支持早期研究结果，即帕洛诺司琼在预防中耳手术患者PONV方面在统计学上比其他两种制剂更有效。（2019；80：XXXXXX）
