Palonosetron for postoperative nausea and vomiting after gynecological laparoscopic surgery: Comparison of its effect on sevoflurane vs desflurane vs total intravenous anesthesia

ABSTRACT

BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the most common complications after gynecological laparoscopic surgery and it appears more frequently after use of inhalation anesthetics than total intravenous anesthesia (TIVA). Palonosetron was introduced as a new-generation potent antiemetic agent, which may reduce PONV more effectively than previous drugs. The aim of this study was to evaluate whether palonosetron could prevent PONV after gynecological laparoscopic surgery, regardless of the anesthetic technique employed. METHODS: Seventy-three patients scheduled for gynecological laparoscopic surgery were randomly assigned into 3 groups according to the anesthetic agent employed (group 1 inhalation anesthesia with desflurane, group 2 inhalation anesthesia with sevoflurane, group 3 total intravenous anesthesia with propofol and remifentanil). Palonosetron 0.075 mg was administered intravenously before the induction. Opioids were not used for postoperative pain control. The incidences of nausea, vomiting and side effects were recorded from 2 hr upto 48 hr, postoperatively. RESULTS: There were no significant differences in the incidence of PONV, severity of nausea, and the use of rescue antiemetics among the groups, throughout the observation. No differences were observed in the adverse side effects among the groups. CONCLUSIONS: Palonosetron decreased the incidence of PONV after gynecological laparoscopic surgery to a similar level, regardless of the anesthetic technique.