title: Evaluation of weight-adjusted doses of palonosetron for prevention of postoperative nausea and vomiting in day care laparoscopic gynaecological surgery: A dose ranging, randomised controlled trial.
abstract: BACKGROUND
  Palonosetron 75 mcg is being used for the prevention of postoperative nausea and vomiting. However, weight-adjusted doses in laparoscopic surgery are unevaluated.
  
  
  OBJECTIVE
  To determine the response to three doses of palonosetron (0.5, 1.0, or 1.5 mcg kg⁻¹) over 72 h in the postoperative period in women undergoing laparoscopic gynaecological procedures.
  
  
  METHODS
  A randomised dose-response study.
  
  
  METHODS
  A tertiary care hospital and research institute in north India from July to December 2014.
  
  
  METHODS
  American society of Anesthesiologists physical status I and II women, from 18 to 60 years old, undergoing laparoscopic gynaecological procedures on a day care basis.
  
  
  METHODS
  Patients were randomised to receive palonosetron 0.5, 1 and 1.5 mcg kg⁻¹ intravenously before induction of anaesthesia.
  
  
  METHODS
  The primary outcome was the proportion of patients with a complete response (i.e. who neither vomited nor required additional antiemetic drugs for nausea during the first 72 postoperative hours). The proportion of patients having nausea or emetic episodes and the requirement for rescue antiemetics and analgesics during the 72-h period were recorded as secondary outcomes.
  
  
  RESULTS
  With palonosetron, there was a significant dose-dependent increase (37.5 vs. 67.5 vs. 75%, P < 0.001) in proportion of patients with a complete response during the 72 h. This was associated with a significant dose-dependent decrease in the proportion of patients with nausea (77.5 vs. 47.5 vs. 35%, P < 0.001) and vomiting (47.5 vs. 32.5 vs. 12.5%, P = 0.003).
  
  
  CONCLUSIONS
  Following laparoscopic gynaecological surgery, intravenous palonosetron has a dose-dependent prophylactic effect against postoperative nausea and vomiting during the first 72 postoperative hours.
  
  
  BACKGROUND
  The trial was registered with Clinical trial registry of India(CTRI/2014/09/004987).
authors.affiliation: From the Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India (DJ, KJ, IB, KG).
authors.forename: Divya
authors.initials: D
authors.lastname: Jain
authors.forename: Kajal
authors.initials: K
authors.lastname: Jain
authors.forename: Indu
authors.initials: I
authors.lastname: Bala
authors.forename: Komal
authors.initials: K
authors.lastname: Gandhi
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects*; D001835:Body Weight; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D054796:Drug Dosage Calculations; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007194:India; D007546:Isoquinolines / Q000008:administration & dosage* / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D000077924:Palonosetron; D020250:Postoperative Nausea and Vomiting / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D011812:Quinuclidines / Q000008:administration & dosage* / Q000009:adverse effects; D012702:Serotonin Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007546:Isoquinolines; D011812:Quinuclidines; D012702:Serotonin Antagonists; D000077924:Palonosetron