title: A randomized, double-blind trial evaluating the efficacy of palonosetron with total intravenous anesthesia using propofol and remifentanil for the prevention of postoperative nausea and vomiting after gynecologic surgery.
abstract: Palonosetron has potent and long-acting antiemetic effects for postoperative nausea and vomiting (PONV). The aim of this study was to prospectively evaluate the efficacy of palonosetron when used with total intravenous anesthesia (TIVA) using propofol and remifentanil for the prevention of PONV in patients undergoing laparoscopic gynecologic surgery.
  
  
  
  This prospective double-blind study comprised 100 female American Society of Anesthesiologist physical status I and II patients who were undergoing laparoscopic gynecologic surgery under TIVA. The patients were randomly assigned to two groups-the palonosetron plus TIVA group (palonosetron 0.075 mg i.v., n = 50) and the TIVA group (normal saline 1.5 ml i.v., n = 50). The treatments were given before the induction of anesthesia. The incidence of PONV, severity, number of rescue antiemetics, adverse effects, and patient satisfaction during the first 24 h after surgery were evaluated.
  
  
  
  The demographic profiles of the patients in the two groups were comparable. The overall incidence of PONV (0-24 h) was significantly lower in the TIVA plus palonosetron group than in the TIVA group (34 vs 58 %, p = 0.027). In particular, during the 6-24 h after surgery, the incidence of PONV (14 vs 30 %, p = 0.03) and the incidence of moderate to severe nausea (6 vs 22 %, p = 0.041) were significantly lower in the TIVA plus palonosetron group than in the TIVA group. There were no significant differences in adverse effects, use of rescue antiemetics or patient satisfaction.
  
  
  
  Combining palonosetron with TIVA can be considered as a good method to prevent PONV, not only during the short postoperative period but also especially during the 6-24-h period after anesthesia.
authors.affiliation: Department of Anesthesiology and Pain Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
authors.forename: Yun-Sic
authors.initials: YS
authors.lastname: Bang
authors.affiliation: Department of Anesthesiology and Pain Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
authors.forename: Young Uk
authors.initials: YU
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7 Keun Jaebong Road, Hwaseong, Gyeonggi, Korea.
authors.forename: Dawoon
authors.initials: D
authors.lastname: Oh
authors.affiliation: Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7 Keun Jaebong Road, Hwaseong, Gyeonggi, Korea.
authors.forename: Eui Yong
authors.initials: EY
authors.lastname: Shin
authors.affiliation: Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7 Keun Jaebong Road, Hwaseong, Gyeonggi, Korea. hardmong@naver.com.
authors.forename: Soo Kyoung
authors.initials: SK
authors.lastname: Park
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000379:methods; D000771:Anesthesia, Intravenous / Q000379:methods; D000932:Antiemetics / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D015994:Incidence; D007546:Isoquinolines / Q000008:administration & dosage*; D010535:Laparoscopy; D008875:Middle Aged; D000077924:Palonosetron; D017060:Patient Satisfaction; D010880:Piperidines / Q000008:administration & dosage*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D011812:Quinuclidines / Q000008:administration & dosage*; D000077208:Remifentanil
chemical_list: D000932:Antiemetics; D007546:Isoquinolines; D010880:Piperidines; D011812:Quinuclidines; D000077924:Palonosetron; D000077208:Remifentanil; D015742:Propofol
keywords: Palonosetron; Postoperative nausea and vomiting; Total intravenous anesthesia