Randomized trial compares palonosetron to ondansetron for preventing nausea and pruritus in cesarean delivery, indicating potential benefits of the newer drug.
( Anesth Analg . 2025;140(3):628-635. doi: 10.1213/ANE.0000000000007091) Spinal anesthesia is preferred for cesarean deliveries (CDs) due to its benefits, such as avoiding pulmonary aspiration and providing better pain control. However, intrathecal (IT) opioids used during the procedure can lead to side effects like postoperative nausea and vomiting (PONV) and pruritus, affecting up to 80% and 83% of patients, respectively. Ondansetron is commonly used for PONV prophylaxis, and palonosetron, a second-generation 5-HT 3 receptor antagonist with a longer half-life and stronger receptor affinity, may offer better results. Although palonosetron has shown superior efficacy in preventing PONV during general anesthesia and in CDs compared with other medications, limited studies have directly compared it with ondansetron. This study aimed to fill that gap, hypothesizing that palonosetron would be more effective than ondansetron in preventing IT morphine-induced PONV and pruritus during CD.
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Worravitudomsuk et al. (2025) studied this question.
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