Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1186/s12871-019-0830-7 http://hdl.handle.net/11449/186050 |
Resumo: | Background Hysterectomy is a widely performed surgery and neuraxial anesthesia with intrathecal morphine provides superior quality of recovery. Postoperative nausea and vomiting (PONV) is a frequent problem with intrathecal morphine use. Although palonosetron is effective for prevention of PONV after general anesthesia, its efficacy after neuraxial anesthesia has not been established. This study was conducted to compare the use of palonosetron with ondansetron for PONV prophylaxis in patients at a high risk of PONV during total abdominal hysterectomy (TAH) under spinal anesthesia with intrathecal morphine. Methods This prospective, randomized double-blind study conducted at Sao Rafael Hospital involved 140 American Society of Anesthesiologists physical status I or II women who underwent TAH under spinal anesthesia with intrathecal morphine and who had at least 3 risk factors for PONV based on Apfel's simplified score. The patients were randomized into two groups: one received palonosetron whereas the other received ondansetron. All patients received spinal anesthesia with intrathecal morphine, as well as dexamethasone plus palonosetron or ondansetron for PONV prophylaxis. The overall incidence of PONV, incidence of early- and late-onset nausea and vomiting, severity of nausea, and use of rescue antiemetics were recorded. Results The overall incidence of PONV was 42.9% in the palonosetron group and 52.9% in the ondansetron group (p > 0.05). No significant differences existed in the incidence of early- and late-onset nausea or early-onset vomiting between the two groups. The incidence of late-onset vomiting was significantly lower in the palonosetron group. Conclusions Palonosetron exhibited efficacy similar to that of ondansetron for reducing the overall incidence of PONV after TAH under spinal anesthesia with intrathecal morphine; however, palonosetron reduced the incidence of late-onset vomiting significantly better than ondansetron. |
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Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trialAntiemeticsMorphineOndansetronPostoperative nausea and vomitingSpinal anesthesiaBackground Hysterectomy is a widely performed surgery and neuraxial anesthesia with intrathecal morphine provides superior quality of recovery. Postoperative nausea and vomiting (PONV) is a frequent problem with intrathecal morphine use. Although palonosetron is effective for prevention of PONV after general anesthesia, its efficacy after neuraxial anesthesia has not been established. This study was conducted to compare the use of palonosetron with ondansetron for PONV prophylaxis in patients at a high risk of PONV during total abdominal hysterectomy (TAH) under spinal anesthesia with intrathecal morphine. Methods This prospective, randomized double-blind study conducted at Sao Rafael Hospital involved 140 American Society of Anesthesiologists physical status I or II women who underwent TAH under spinal anesthesia with intrathecal morphine and who had at least 3 risk factors for PONV based on Apfel's simplified score. The patients were randomized into two groups: one received palonosetron whereas the other received ondansetron. All patients received spinal anesthesia with intrathecal morphine, as well as dexamethasone plus palonosetron or ondansetron for PONV prophylaxis. The overall incidence of PONV, incidence of early- and late-onset nausea and vomiting, severity of nausea, and use of rescue antiemetics were recorded. Results The overall incidence of PONV was 42.9% in the palonosetron group and 52.9% in the ondansetron group (p > 0.05). No significant differences existed in the incidence of early- and late-onset nausea or early-onset vomiting between the two groups. The incidence of late-onset vomiting was significantly lower in the palonosetron group. Conclusions Palonosetron exhibited efficacy similar to that of ondansetron for reducing the overall incidence of PONV after TAH under spinal anesthesia with intrathecal morphine; however, palonosetron reduced the incidence of late-onset vomiting significantly better than ondansetron.Sao Rafael Hosp, Dor Inst Res & Educ IDOR, Dept Anesthesiol, Salvador, BA, BrazilCardiopulmonar Hosp, Dept Anesthesiol, Salvador, BA, BrazilSao Paulo State Univ, Dept Anesthesiol, Botucatu, SP, BrazilUniv Fed Bahia, Salvador, BA, BrazilSao Rafael Hosp, Dor Inst Res & Educ IDOR, Dept Gynecol, Salvador, BA, BrazilSanto Antonio Hosp, Dept Anesthesiol, Salvador, BA, BrazilSao Paulo State Univ, Dept Anesthesiol, Botucatu, SP, BrazilBmcSao Rafael HospCardiopulmonar HospUniversidade Estadual Paulista (Unesp)Universidade Federal da Bahia (UFBA)Santo Antonio HospCampos, Guilherme OliveiraMartins, Marcelo de Jesus [UNESP]Jesus, Gabriel NascimentoRios de Oliveira, Paulo RobertoLessa, Caio NogueiraMacedo Fernandes de Oliveira Junior, Joao CarlosSantana de Castro Alves, Lucas JorgeAlves, Rodrigo LealPinheiro Modolo, Norma Sueli [UNESP]2019-10-04T12:40:50Z2019-10-04T12:40:50Z2019-08-17info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article6http://dx.doi.org/10.1186/s12871-019-0830-7Bmc Anesthesiology. London: Bmc, v. 19, n. 1, 6 p., 2019.1471-2253http://hdl.handle.net/11449/18605010.1186/s12871-019-0830-7WOS:000481750100004Web of Sciencereponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengBmc Anesthesiologyinfo:eu-repo/semantics/openAccess2024-08-14T13:20:05Zoai:repositorio.unesp.br:11449/186050Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-14T13:20:05Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial |
title |
Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial |
spellingShingle |
Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial Campos, Guilherme Oliveira Antiemetics Morphine Ondansetron Postoperative nausea and vomiting Spinal anesthesia |
title_short |
Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial |
title_full |
Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial |
title_fullStr |
Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial |
title_full_unstemmed |
Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial |
title_sort |
Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial |
author |
Campos, Guilherme Oliveira |
author_facet |
Campos, Guilherme Oliveira Martins, Marcelo de Jesus [UNESP] Jesus, Gabriel Nascimento Rios de Oliveira, Paulo Roberto Lessa, Caio Nogueira Macedo Fernandes de Oliveira Junior, Joao Carlos Santana de Castro Alves, Lucas Jorge Alves, Rodrigo Leal Pinheiro Modolo, Norma Sueli [UNESP] |
author_role |
author |
author2 |
Martins, Marcelo de Jesus [UNESP] Jesus, Gabriel Nascimento Rios de Oliveira, Paulo Roberto Lessa, Caio Nogueira Macedo Fernandes de Oliveira Junior, Joao Carlos Santana de Castro Alves, Lucas Jorge Alves, Rodrigo Leal Pinheiro Modolo, Norma Sueli [UNESP] |
author2_role |
author author author author author author author author |
dc.contributor.none.fl_str_mv |
Sao Rafael Hosp Cardiopulmonar Hosp Universidade Estadual Paulista (Unesp) Universidade Federal da Bahia (UFBA) Santo Antonio Hosp |
dc.contributor.author.fl_str_mv |
Campos, Guilherme Oliveira Martins, Marcelo de Jesus [UNESP] Jesus, Gabriel Nascimento Rios de Oliveira, Paulo Roberto Lessa, Caio Nogueira Macedo Fernandes de Oliveira Junior, Joao Carlos Santana de Castro Alves, Lucas Jorge Alves, Rodrigo Leal Pinheiro Modolo, Norma Sueli [UNESP] |
dc.subject.por.fl_str_mv |
Antiemetics Morphine Ondansetron Postoperative nausea and vomiting Spinal anesthesia |
topic |
Antiemetics Morphine Ondansetron Postoperative nausea and vomiting Spinal anesthesia |
description |
Background Hysterectomy is a widely performed surgery and neuraxial anesthesia with intrathecal morphine provides superior quality of recovery. Postoperative nausea and vomiting (PONV) is a frequent problem with intrathecal morphine use. Although palonosetron is effective for prevention of PONV after general anesthesia, its efficacy after neuraxial anesthesia has not been established. This study was conducted to compare the use of palonosetron with ondansetron for PONV prophylaxis in patients at a high risk of PONV during total abdominal hysterectomy (TAH) under spinal anesthesia with intrathecal morphine. Methods This prospective, randomized double-blind study conducted at Sao Rafael Hospital involved 140 American Society of Anesthesiologists physical status I or II women who underwent TAH under spinal anesthesia with intrathecal morphine and who had at least 3 risk factors for PONV based on Apfel's simplified score. The patients were randomized into two groups: one received palonosetron whereas the other received ondansetron. All patients received spinal anesthesia with intrathecal morphine, as well as dexamethasone plus palonosetron or ondansetron for PONV prophylaxis. The overall incidence of PONV, incidence of early- and late-onset nausea and vomiting, severity of nausea, and use of rescue antiemetics were recorded. Results The overall incidence of PONV was 42.9% in the palonosetron group and 52.9% in the ondansetron group (p > 0.05). No significant differences existed in the incidence of early- and late-onset nausea or early-onset vomiting between the two groups. The incidence of late-onset vomiting was significantly lower in the palonosetron group. Conclusions Palonosetron exhibited efficacy similar to that of ondansetron for reducing the overall incidence of PONV after TAH under spinal anesthesia with intrathecal morphine; however, palonosetron reduced the incidence of late-onset vomiting significantly better than ondansetron. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-10-04T12:40:50Z 2019-10-04T12:40:50Z 2019-08-17 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1186/s12871-019-0830-7 Bmc Anesthesiology. London: Bmc, v. 19, n. 1, 6 p., 2019. 1471-2253 http://hdl.handle.net/11449/186050 10.1186/s12871-019-0830-7 WOS:000481750100004 |
url |
http://dx.doi.org/10.1186/s12871-019-0830-7 http://hdl.handle.net/11449/186050 |
identifier_str_mv |
Bmc Anesthesiology. London: Bmc, v. 19, n. 1, 6 p., 2019. 1471-2253 10.1186/s12871-019-0830-7 WOS:000481750100004 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Bmc Anesthesiology |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
6 |
dc.publisher.none.fl_str_mv |
Bmc |
publisher.none.fl_str_mv |
Bmc |
dc.source.none.fl_str_mv |
Web of Science reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1808128105534980096 |