Cargando…

Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial

BACKGROUND: Hysterectomy is a widely performed surgery and neuraxial anesthesia with intrathecal morphine provides superior quality of recovery. Postoperative nausea and vomiting (PONV) is a frequent problem with intrathecal morphine use. Although palonosetron is effective for prevention of PONV aft...

Descripción completa

Detalles Bibliográficos
Autores principales: Campos, Guilherme Oliveira, de Jesus Martins, Marcelo, Jesus, Gabriel Nascimento, de Oliveira, Paulo Roberto Rios, Lessa, Caio Nogueira, de Oliveira Junior, João Carlos Macêdo Fernandes, de Castro Alves, Lucas Jorge Santana, Alves, Rodrigo Leal, Módolo, Norma Sueli Pinheiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698358/
https://www.ncbi.nlm.nih.gov/pubmed/31421679
http://dx.doi.org/10.1186/s12871-019-0830-7
_version_ 1783444537874579456
author Campos, Guilherme Oliveira
de Jesus Martins, Marcelo
Jesus, Gabriel Nascimento
de Oliveira, Paulo Roberto Rios
Lessa, Caio Nogueira
de Oliveira Junior, João Carlos Macêdo Fernandes
de Castro Alves, Lucas Jorge Santana
Alves, Rodrigo Leal
Módolo, Norma Sueli Pinheiro
author_facet Campos, Guilherme Oliveira
de Jesus Martins, Marcelo
Jesus, Gabriel Nascimento
de Oliveira, Paulo Roberto Rios
Lessa, Caio Nogueira
de Oliveira Junior, João Carlos Macêdo Fernandes
de Castro Alves, Lucas Jorge Santana
Alves, Rodrigo Leal
Módolo, Norma Sueli Pinheiro
author_sort Campos, Guilherme Oliveira
collection PubMed
description BACKGROUND: Hysterectomy is a widely performed surgery and neuraxial anesthesia with intrathecal morphine provides superior quality of recovery. Postoperative nausea and vomiting (PONV) is a frequent problem with intrathecal morphine use. Although palonosetron is effective for prevention of PONV after general anesthesia, its efficacy after neuraxial anesthesia has not been established. This study was conducted to compare the use of palonosetron with ondansetron for PONV prophylaxis in patients at a high risk of PONV during total abdominal hysterectomy (TAH) under spinal anesthesia with intrathecal morphine. METHODS: This prospective, randomized double-blind study conducted at São Rafael Hospital involved 140 American Society of Anesthesiologists physical status I or II women who underwent TAH under spinal anesthesia with intrathecal morphine and who had at least 3 risk factors for PONV based on Apfel’s simplified score. The patients were randomized into two groups: one received palonosetron whereas the other received ondansetron. All patients received spinal anesthesia with intrathecal morphine, as well as dexamethasone plus palonosetron or ondansetron for PONV prophylaxis. The overall incidence of PONV, incidence of early- and late-onset nausea and vomiting, severity of nausea, and use of rescue antiemetics were recorded. RESULTS: The overall incidence of PONV was 42.9% in the palonosetron group and 52.9% in the ondansetron group (p > 0.05). No significant differences existed in the incidence of early- and late-onset nausea or early-onset vomiting between the two groups. The incidence of late-onset vomiting was significantly lower in the palonosetron group. CONCLUSIONS: Palonosetron exhibited efficacy similar to that of ondansetron for reducing the overall incidence of PONV after TAH under spinal anesthesia with intrathecal morphine; however, palonosetron reduced the incidence of late-onset vomiting significantly better than ondansetron. TRIAL REGISTRATION: RBR-4gnm8n (ensaiosclinicos.gov.br), date of registration: August 18, 2014.
format Online
Article
Text
id pubmed-6698358
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-66983582019-08-22 Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial Campos, Guilherme Oliveira de Jesus Martins, Marcelo Jesus, Gabriel Nascimento de Oliveira, Paulo Roberto Rios Lessa, Caio Nogueira de Oliveira Junior, João Carlos Macêdo Fernandes de Castro Alves, Lucas Jorge Santana Alves, Rodrigo Leal Módolo, Norma Sueli Pinheiro BMC Anesthesiol Research Article BACKGROUND: Hysterectomy is a widely performed surgery and neuraxial anesthesia with intrathecal morphine provides superior quality of recovery. Postoperative nausea and vomiting (PONV) is a frequent problem with intrathecal morphine use. Although palonosetron is effective for prevention of PONV after general anesthesia, its efficacy after neuraxial anesthesia has not been established. This study was conducted to compare the use of palonosetron with ondansetron for PONV prophylaxis in patients at a high risk of PONV during total abdominal hysterectomy (TAH) under spinal anesthesia with intrathecal morphine. METHODS: This prospective, randomized double-blind study conducted at São Rafael Hospital involved 140 American Society of Anesthesiologists physical status I or II women who underwent TAH under spinal anesthesia with intrathecal morphine and who had at least 3 risk factors for PONV based on Apfel’s simplified score. The patients were randomized into two groups: one received palonosetron whereas the other received ondansetron. All patients received spinal anesthesia with intrathecal morphine, as well as dexamethasone plus palonosetron or ondansetron for PONV prophylaxis. The overall incidence of PONV, incidence of early- and late-onset nausea and vomiting, severity of nausea, and use of rescue antiemetics were recorded. RESULTS: The overall incidence of PONV was 42.9% in the palonosetron group and 52.9% in the ondansetron group (p > 0.05). No significant differences existed in the incidence of early- and late-onset nausea or early-onset vomiting between the two groups. The incidence of late-onset vomiting was significantly lower in the palonosetron group. CONCLUSIONS: Palonosetron exhibited efficacy similar to that of ondansetron for reducing the overall incidence of PONV after TAH under spinal anesthesia with intrathecal morphine; however, palonosetron reduced the incidence of late-onset vomiting significantly better than ondansetron. TRIAL REGISTRATION: RBR-4gnm8n (ensaiosclinicos.gov.br), date of registration: August 18, 2014. BioMed Central 2019-08-17 /pmc/articles/PMC6698358/ /pubmed/31421679 http://dx.doi.org/10.1186/s12871-019-0830-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Campos, Guilherme Oliveira
de Jesus Martins, Marcelo
Jesus, Gabriel Nascimento
de Oliveira, Paulo Roberto Rios
Lessa, Caio Nogueira
de Oliveira Junior, João Carlos Macêdo Fernandes
de Castro Alves, Lucas Jorge Santana
Alves, Rodrigo Leal
Módolo, Norma Sueli Pinheiro
Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial
title Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial
title_full Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial
title_fullStr Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial
title_full_unstemmed Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial
title_short Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial
title_sort palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomized controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698358/
https://www.ncbi.nlm.nih.gov/pubmed/31421679
http://dx.doi.org/10.1186/s12871-019-0830-7
work_keys_str_mv AT camposguilhermeoliveira palonosetronversusondansetronforpreventionofnauseaandvomitingaftertotalabdominalhysterectomyunderspinalanesthesiawithintrathecalmorphineadoubleblindrandomizedcontrolledtrial
AT dejesusmartinsmarcelo palonosetronversusondansetronforpreventionofnauseaandvomitingaftertotalabdominalhysterectomyunderspinalanesthesiawithintrathecalmorphineadoubleblindrandomizedcontrolledtrial
AT jesusgabrielnascimento palonosetronversusondansetronforpreventionofnauseaandvomitingaftertotalabdominalhysterectomyunderspinalanesthesiawithintrathecalmorphineadoubleblindrandomizedcontrolledtrial
AT deoliveirapaulorobertorios palonosetronversusondansetronforpreventionofnauseaandvomitingaftertotalabdominalhysterectomyunderspinalanesthesiawithintrathecalmorphineadoubleblindrandomizedcontrolledtrial
AT lessacaionogueira palonosetronversusondansetronforpreventionofnauseaandvomitingaftertotalabdominalhysterectomyunderspinalanesthesiawithintrathecalmorphineadoubleblindrandomizedcontrolledtrial
AT deoliveirajuniorjoaocarlosmacedofernandes palonosetronversusondansetronforpreventionofnauseaandvomitingaftertotalabdominalhysterectomyunderspinalanesthesiawithintrathecalmorphineadoubleblindrandomizedcontrolledtrial
AT decastroalveslucasjorgesantana palonosetronversusondansetronforpreventionofnauseaandvomitingaftertotalabdominalhysterectomyunderspinalanesthesiawithintrathecalmorphineadoubleblindrandomizedcontrolledtrial
AT alvesrodrigoleal palonosetronversusondansetronforpreventionofnauseaandvomitingaftertotalabdominalhysterectomyunderspinalanesthesiawithintrathecalmorphineadoubleblindrandomizedcontrolledtrial
AT modolonormasuelipinheiro palonosetronversusondansetronforpreventionofnauseaandvomitingaftertotalabdominalhysterectomyunderspinalanesthesiawithintrathecalmorphineadoubleblindrandomizedcontrolledtrial