COMPARATIVE EVALUATION OF SINGLE DOSE PALONOSETRON AND GRANISETRON IN MIDDLE EAR SURGERIES FOR PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING.

Background and aims: Palonosetron 5HT 3 antagonist have been evaluated in delayed chemotherapy induced nausea and vomiting but its antiemetic efficacy after middle ear surgery is less clear which is high risk for post operative nausea and vomiting.( PONV). This study aimed to evaluate whether Palonosetron conferred any advantage over Granisetron in terms of duration of prophylaxis and its effect on the incidence and severity of PONV in patients undergoing middle ear surgeries (MES) when used as single dose prophylactic antiemetic. Methods: One hundred ASA I and II patients of either gender aged 18 to 60 were randomly assigned into group P (Palonosetron n=50) or group G( Granisetron n=50), by computerised randomisation. Analysis was done in terms of incidence and severity of nausea, vomiting and rescue antiemetic usage till 72 hours of surgery. Results: During 72 hours, group P had more number of complete responders than in group G (56% vs. 34%). This difference was more significant after 24hours. 50% of patients in group G as against 28% in group required rescue antiemetic. Conclusion: Single dose prophylactic Palonosetron 0.075 mg and 2.5 mg Granisetron conferred similar protection against postoperative nausea and vomiting for initial six hours postoperatively but Palonosetron was more effective than Granisetron for long term prophylaxis over 72 hours against PONV after MES without significant adverse effects.