J Minim Invasive Surg.
2024 Dec;27(4):202-216. 10.7602/jmis.2024.27.4.202.
Comparison of efficacy and safety between palonosetron and ondansetron to prevent postoperative nausea and vomiting in patients undergoing laparoscopic surgery: a systematic review and meta-analysis
- Kumar J
1 - Alagarsamy R2
- Lal B3
- Rai AJ1
- Joshi R4
- Karna ST5
- Shakti P6
- Verma DK7
- Yadav V8
- Goel P1
- Yunus M3
- Barathi A9
- Affiliations
-
- 1Department of Dentistry, All India Institute of Medical Sciences, Bhopal, India
- 2Department of Burns, Plastic and Maxillofacial Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
- 3Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, India
- 4Department of Medicine, All India Institute of Medical Sciences, Bhopal, India
- 5Department of Anaesthesia, All India Institute of Medical Sciences, Bhopal, India
- 6Department of Plastic Surgery, MLB Medical College & Hospital, Jhansi, India
- 7Department of Dentistry, All India Institute of Medical Sciences, Bilaspur, India
- 8Department of Dentistry, Govt Medical College, Gondia, India
- 9Department of Community Medicine, ESIC Medical College and Hospital, Chennai, India
- KMID: 2562460
- DOI: http://doi.org/10.7602/jmis.2024.27.4.202
Abstract
- Purpose
Postoperative nausea and vomiting (PONV) is a prevalent and distressing complication, especially in laparoscopic surgeries. This review compares the efficacy and safety of palonosetron and ondansetron in preventing PONV after laparoscopic surgery.
Methods
A systematic review was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library to identify comparative studies that reported the efficacy (nausea and vomiting) at three postoperative time points T1 (0–2 hours), T2 (2–6 hours), T3 (6–24 hours) and safety (incidence of adverse effects). Meta-analysis of relative risk was performed using a random effect model and subgroup analysis based on factors such as antiemetic dose and timing of administration, type of surgery, and anesthetic agents.
Results
Twenty-one randomized controlled trials were published between 2011 and 2022, involving 2,043 participants. Nineteen trials were included in the meta-analysis (efficacy, 17; safety, 11). The pooled risk ratio revealed that patients receiving palonosetron demonstrated significantly less likelihood of developing nausea and vomiting at various postoperative time points. Subgroup analysis indicated significantly less PONV when palonosetron was administered before intubation and in combination with isoflurane anesthesia. Headache, dizziness, constipation, and drowsiness were the most commonly reported. The safety profiles of palonosetron and ondansetron were comparable.
Conclusion
Palonosetron exhibits superior efficacy within the first 24 hours postoperatively and requires less rescue antiemetic intervention compared to ondansetron in laparoscopic surgery patients. Both demonstrate nearly comparable safety profiles. Future trials focusing on cardiac safety (QT interval) and cost consideration are needed.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Comparison of palonosetron with ondansetron in preventing postoperative nausea and vomiting after thyroidectomy during a 48-hour period
- Comparison of palonosetron with ondansetron in prevention of postoperative nausea and vomiting in patients receiving intravenous patient-controlled analgesia after gynecological laparoscopic surgery
- Comparison of palonosetron and ondansetron to prevent postoperative nausea and vomiting in women using intravenous patient-controlled analgesia
- Palonosetron has superior prophylactic antiemetic efficacy compared with ondansetron or ramosetron in high-risk patients undergoing laparoscopic surgery: a prospective, randomized, double-blinded study
- Comparative Study of Ondansetron versus Placebo to Prevent Postoperative Nausea and Vomiting in those Undergoing Abdominal Surgery
