title: Efficacy of palonosetron for preventing postoperative nausea and vomiting: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Palonosetron, a second-generation 5-hydroxytryptamine 3 receptor antagonist (5-HT3RA), has unique characteristics relative to first-generation 5-HT3RAs such as ondansetron. Nevertheless, it remains unclear if palonosetron is better than ondansetron for the prevention of nausea and vomiting during the first 24 hr after surgery and is thus the focus of this systematic review.
  
  
  METHODS
  We conducted a systematic search of the MEDLINE®, EMBASE™, Cochrane Central Register of Controlled Trials and Web of Science® databases to identify randomized controlled trials (RCTs) that addressed a comparison of the prophylactic antiemetic efficacy between palonosetron and ondansetron within 24 hr after surgery. The primary outcomes were the proportion of participants who experienced postoperative nausea (PON), postoperative vomiting (POV), or both, in the early (0-6 hr) or late (6-24 hr) period. The pooled relative risks (RRs) were calculated along with their corresponding 95% confidence intervals (CIs).
  
  
  RESULTS
  We identified nine RCTs that comprised 741 participants. Palonosetron was superior to ondansetron in the reduction of early PON [RR, 0.51; 95% CI, 0.37 to 0.71], late PON (RR, 0.53; 95% CI, 0.36 to 0.77), and late POV (RR, 0.41; 95% CI, 0.28 to 0.62), but not early POV (RR, 0.77; 95% CI, 0.45 to 1.34).
  
  
  CONCLUSIONS
  Palonosetron provides more effective prophylaxis of early PON, late PON, and late POV compared with ondansetron. Future studies are required to investigate the role of palonosetron during 24-72 hr following surgery.
authors: Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongtinan Road, Chaoyang District, Beijing, 100020, China.
authors: Chao
authors: C
authors: Xiong
authors: Department of Anesthesiology, Xuan Wu Hospital, Capital Medical University, Beijing, China.
authors: Guangyu
authors: G
authors: Liu
authors: Department of Anesthesiology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
authors: Ruolan
authors: R
authors: Ma
authors: Department of Anesthesiology, Xuan Wu Hospital, Capital Medical University, Beijing, China.
authors: Jixiu
authors: J
authors: Xue
authors: Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongtinan Road, Chaoyang District, Beijing, 100020, China. wuanshi1965@163.com.
authors: Anshi
authors: A
authors: Wu
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D006801:Humans; D007546:Isoquinolines / Q000627:therapeutic use*; D017294:Ondansetron / Q000627:therapeutic use; D000077924:Palonosetron; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000517:prevention & control*; D011812:Quinuclidines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors
chemical_list: D000932:Antiemetics; D007546:Isoquinolines; D011812:Quinuclidines; D017294:Ondansetron; D000077924:Palonosetron