Higher dose of palonosetron versus lower dose of palonosetron plus droperidol to prevent postoperative nausea and vomiting after eye enucleation and orbital hydroxyapatite implant surgery: a randomized, double-blind trial

Xiao Hu, Fang Tan, Lan Gong Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Medical College of Fudan University, Shanghai, China Objective: Postoperative nausea and vomiting (PONV) is commonly observed after eye enucleation and orb...

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Main Authors: Hu X (Author), Tan F (Author), Gong L (Author)
Format: Book
Published: Dove Medical Press, 2017-05-01T00:00:00Z.
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Summary:Xiao Hu, Fang Tan, Lan Gong Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai&nbsp;Medical College of Fudan University, Shanghai,&nbsp;China Objective: Postoperative nausea and vomiting (PONV) is commonly observed after eye enucleation and orbital hydroxyapatite implant surgery. This prospective, randomized, double-blind trial was conducted to investigate the hypothesis that compared with monotherapy using a higher dose of palonosetron, using a lower dose of palonosetron in combination with droperidol could reduce the incidence of PONV and achieve similar prophylaxis against PONV after the aforementioned surgery.Patients and methods: A total of 129 patients who were in the American Society of Anesthesiologists Classes I and II, aged between 18 and 70 years, and scheduled for eye enucleation and orbital hydroxyapatite implant surgery, were enrolled in this study. They were randomized into three groups: Group P2.5 (2.5&nbsp;&micro;g/kg palonosetron), Group P7.5 (7.5&nbsp;&micro;g/kg palonosetron), and Group&nbsp;P+D (2.5&nbsp;&micro;g/kg palonosetron and 15&nbsp;&micro;g/kg droperidol). Patients received the different antiemetic regimens intravenously 5&nbsp;min before surgery. The severity of nausea and vomiting and the complete response (CR) rate during a 72-h postoperative period were assessed.Results: All patients completed the trial. The nausea score of Group P2.5 was significantly higher than those of the other two groups at 0&ndash;4&nbsp;h and 24&ndash;48&nbsp;h (P<0.05). Vomiting scores among all groups were similar during all intervals (P>0.05). Compared with Group P2.5, the CR rate was significantly improved at all intervals in Group P+D, except at 4&ndash;72&nbsp;h, and was also elevated at 24&ndash;72&nbsp;h in Group P7.5 (P<0.05). Fewer patients in Group P2.5 did not experience any nausea or vomiting throughout the study (49%) compared with those in Group P7.5 (67%) and Group P+D (81%; P<0.01).Conclusion: Combining low-dose palonosetron with droperidol potentiated prophylaxis for PONV and achieved a similar prophylactic effect as that with a higher dose of palonosetron. Keywords: eye enucleation, orbital hydroxyapatite implant, palonosetron, PONV
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