Comparison of Ondansetron and Palonosetron on Postoperative Nausea and Vomiting in Patients Undergoing Maxillofacial...

The aim of this study was to evaluate the effectiveness of intravenous ondansetron in comparison with palonosetron during the first 24 hours post-maxillofacial surgery.

A prospective, randomized, double-blind, clinical trial was carried out in 40 patients who underwent Maxillofacial surgery under general anesthesia. Patients were randomized to receive either ondansetron 4 mg (group A) or palonosetron 0.075 mg (group B), administered by intravenous injection 30 min prior to intubation. A coin-flipping randomization method was used. Nausea and vomiting incidence was assessed after every one hour for the first 6 hours and then from 6 to 24^th hours postoperatively.

The current study result shows that overall incidence of postoperative nausea and vomiting is 50% {nausea (n = 13) + vomiting (n = 7)} in both the groups after maxillofacial surgeries during 6^th to 24^th hours. However, the efficacy of ondansetron and palonosetron is equal in early hours with statistically not significant. Palonosetron is slightly more effective than ondansetron in late hours with statistically not significant. As per Apfel's scoring system, both groups have almost equal risk scores (group A, 1 = 3, 2 = 11, 3 = 6) and (group B, 1 = 4, 2 = 10, 3 = 6).

Both ondansetron and palonosetron are equally effective for the early postoperative hours (first six hours); thereafter, palonosetron is slightly more effective than ondansetron in the late postoperative period (6^th to 24th hours) for the prevention of PONV following Maxillofacial surgeries under general anesthesia.