Korean J Anesthesiol.  2014 Jul;67(1):13-19. 10.4097/kjae.2014.67.1.13.

Effects of pretreatment with intravenous palonosetron for propofol-remifentanil-based anesthesia in breast and thyroid cancer surgery: a double-blind, randomized, controlled study

• Lee KH
• Rim SK
• Lee JY
• Lee SY
• Lee SN
• Lee EJ
• Lee JH

• KMID: 2236200
• DOI: http://doi.org/10.4097/kjae.2014.67.1.13

Abstract

BACKGROUND
We postulated that palonosetron, a novel antiemetic agent, might have the effect of alleviating injection pain from propofol and rocuronium. A double-blind, controlled study was undertaken to evaluate the effect of palonosetron on injection pain during total intravenous anesthesia and postoperative nausea and vomiting (PONV) using propofol-remifentanil in breast and thyroid cancer surgery.
METHODS
Sixty patients were randomly allocated to one of two groups. Before injection of propofol and rocuronium, patients in group S (n = 30) received 4 ml of saline and patients in group P (n = 30) received 75 microg (1.5 ml) of palonosetron mixed with 2.5 ml of saline (n = 30). Patients were evaluated by a blinded anesthesiologist with regard to the scoring of injection pain of propofol, withdrawal response by rocuronium, PONV, shivering, postoperative pain, recall of pain, and overall satisfaction.
RESULTS
The differences between groups in the incidence of injection pain due to propofol and rocuronium were insignificant. However, in group P, the severity of propofol-induced injection pain (3% vs. 33%, P = 0.003) and postoperative pain (P = 0.038) was significantly lower during the first 12 h after surgery. No differences were observed between the groups with respect to PONV, shivering, recall of pain, and overall satisfaction.
CONCLUSIONS
We concluded that pretreatment of palonosetron was effective to reduce the severity of propofol-induced injection pain and early postoperative pain, although it did not reduce the incidence of injection pain from propofol and rocuronium.

Keyword

Pain; Palonosetron; Postoperative nausea and vomiting; Propofol

MeSH Terms

Anesthesia*
Anesthesia, Intravenous
Breast*
Humans
Incidence
Pain, Postoperative
Postoperative Nausea and Vomiting
Propofol
Shivering
Thyroid Neoplasms*
Propofol