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

Detalhes bibliográficos
Autor(a) principal: Campos, Guilherme Oliveira
Data de Publicação: 2019
Outros Autores: 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]
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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spelling 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
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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
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repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
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