title: Comparison of palonosetron with palonosetron-dexamethasone combination for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.
abstract: BACKGROUND
  This randomized double-blind study was designed to compare palonosetron with palonosetron-dexamethasone combination for prevention of post operative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy.
  
  
  METHODS
  Eighty-four adult ASA 1-2 patients were randomly allocated into two groups. Group P patients received 0.075 mg palonosetron and group PD patients received 0.075 mg palonosetron and 8 mg dexamethasone intravenously before induction of anesthesia. Anesthesia was induced with propofol and fentanyl and maintained with N2O-isoflurane in oxygen. All patients received port-site infiltration with bupivacaine and intravenous diclofenac for postoperative analgesia. Metoclopramide was used as rescue antiemetic. Patients were observed for the incidence of PONV and requirement of rescue antiemetic for 48 h after surgery.
  
  
  RESULTS
  The complete response rate (no vomiting) was significantly higher in group DP as compared to group P between 0-24 h (P=0.004). 18 (42.9%) patients reported nausea and 14 (33.3%) patients had vomiting in group P while 6 (14.4%) patients had nausea and 5 (11.9%) patients complained of vomiting in group DP during 0-24 h. Two patients in group P reported nausea while none in group PD during 24-48 h. No patient had vomiting in either of the groups between 24-48 h. The requirement of rescue antiemetic was also less in group DP as compared to group P. Patients in group DP required less postoperative analgesia and were more satisfied with PONV treatment than group P patients.
  
  
  CONCLUSIONS
  The palonosetron-dexamethasone combination was more effective as compared to only palonosetron for reducing PONV after laparoscopic cholecystectomy.
authors.affiliation: Department of Anesthesia and Intensive Care, Pgimer, Chandigarh, India - bhartineerja@yahoo.com.
authors.forename: I
authors.initials: I
authors.lastname: Bala
authors.forename: N
authors.initials: N
authors.lastname: Bharti
authors.forename: S
authors.initials: S
authors.lastname: Murugesan
authors.forename: R
authors.initials: R
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000758:Anesthesia; D000932:Antiemetics / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007546:Isoquinolines / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000077924:Palonosetron; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011812:Quinuclidines / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000932:Antiemetics; D004338:Drug Combinations; D007546:Isoquinolines; D011812:Quinuclidines; D000077924:Palonosetron; D003907:Dexamethasone