title: Effects of Palonosetron on Perioperative Cardiovascular Complications in Patients Undergoing Noncardiac Surgery With General Anesthesia: A Retrospective Cohort Study.
abstract: We retrospectively investigated whether palonosetron administered during the induction of general anesthesia is associated with an increased risk of perioperative cardiovascular complications in a single tertiary center cohort consisting of 4,517 palonosetron-exposed patients and 4,517 propensity score-matched patients without palonosetron exposure. The primary endpoint was a composite of perioperative cardiovascular complications, including intraoperative cardiac arrhythmia, intraoperative cardiac death, and myocardial injury within the first postoperative week, and there was no significant difference between the groups (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 0.92-1.19). As secondary endpoints, intraoperative cardioversion, cardiac compression, use of cardiovascular drugs, postoperative hospital stay, and in-hospital mortality showed no differences between the groups. However, the palonosetron group showed decreased intraoperative hypotension (OR = 0.88; 95% CI = 0.79-0.97) and length of postoperative intensive care unit (ICU) stay (4.26 ± 9.86 vs. 6.14 ± 16.75; P = 0.026). Palonosetron did not increase the rate of perioperative cardiovascular complications, and can therefore be used safely during anesthetic induction.
authors: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors: J J
authors: JJ
authors: Min
authors: Department of Anesthesiology and Pain Medicine, Severance Hospital, Seoul, Republic of Korea.
authors: H J
authors: HJ
authors: Kim
authors: Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Republic of Korea.
authors: S-Y
authors: SY
authors: Jung
authors: Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Republic of Korea.
authors: B G
authors: BG
authors: Kim
authors: Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Republic of Korea.
authors: K
authors: K
authors: Kwon
authors: Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Republic of Korea.
authors: H-J
authors: HJ
authors: Jung
authors: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors: T K
authors: TK
authors: Kim
authors: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors: D M
authors: DM
authors: Hong
authors: Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Republic of Korea.|Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: B-J
authors: BJ
authors: Park
authors: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Y
authors: Y
authors: Jeon
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000932:Antiemetics / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D002319:Cardiovascular System / Q000187:drug effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007546:Isoquinolines / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced; D000077924:Palonosetron; D059035:Perioperative Period; D011812:Quinuclidines / Q000009:adverse effects*; D012189:Retrospective Studies; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000009:adverse effects*
chemical_list: D000932:Antiemetics; D007546:Isoquinolines; D011812:Quinuclidines; D058831:Serotonin 5-HT3 Receptor Antagonists; D000077924:Palonosetron