title: Anti-emetic effect of ondansetron and palonosetron in thyroidectomy: a prospective, randomized, double-blind study.
abstract: BACKGROUND
  Palonosetron is a new potent 5-hydroxytryptamine 3 antagonist. Although this drug is thought to be more effective in patients receiving opioid-based patient-controlled analgesia (PCA), clinical data are lacking. This study compared the effects of i.v. ondansetron and palonosetron administered at the end of surgery in preventing postoperative nausea and vomiting (PONV) in high-risk patients receiving i.v. PCA after thyroidectomy.
  
  
  METHODS
  A total of 100 female non-smoking subjects were randomly assigned into a palonosetron group or an ondansetron group. Ondansetron was given as an 8 mg bolus and 16 mg was added to the i.v. PCA mixture. In the palonosetron group, 0.075 mg was injected as a bolus only. Fentanyl-based PCA was provided for 24 h after operation. The incidence of nausea and vomiting, severity of nausea, requirement for rescue anti-emetics, and adverse effects were evaluated during 0-2 and 2-24 h.
  
  
  RESULTS
  The incidence of PONV during the 24 h postoperative period was lower in the palonosetron group than in the ondansetron group (42% vs 62%, P=0.045). No differences were observed between the groups during the first 2 h. However, the incidence of nausea and vomiting and nausea severity were significantly lower in the palonosetron group than in the ondansetron group during 2-24 h. The only difference in the use of rescue anti-emetics was at 2-24 h (10% with palonosetron compared with 28% with ondansetron, P=0.02).
  
  
  CONCLUSIONS
  Palonosetron is more effective than ondansetron for high-risk patients receiving fentanyl-based PCA after thyroidectomy, especially 2-24 h after surgery.
authors.affiliation: Department of Anaesthesiology and Pain Medicine,  Seoul St Mary' s Hospital, Catholic University College of Medicine, Seoul,  Republic of  Korea.
authors.forename: Y E
authors.initials: YE
authors.lastname: Moon
authors.forename: J
authors.initials: J
authors.lastname: Joo
authors.forename: J E
authors.initials: JE
authors.lastname: Kim
authors.forename: Y
authors.initials: Y
authors.lastname: Lee
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D000932:Antiemetics / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007546:Isoquinolines / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D017294:Ondansetron / Q000009:adverse effects / Q000627:therapeutic use*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control; D000077924:Palonosetron; D011182:Postoperative Care / Q000379:methods; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000517:prevention & control*; D011812:Quinuclidines / Q000009:adverse effects / Q000627:therapeutic use*; D013965:Thyroidectomy / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000932:Antiemetics; D007546:Isoquinolines; D011812:Quinuclidines; D017294:Ondansetron; D000077924:Palonosetron