Efficacy of Palonosetron vs. Ondansetron in Preventing Post-Operative Nausea and Vomiting in Abdominal Surgery Patients: A Comparative

Background: Postoperative nausea and vomiting (PONV) are prevalent complications associated with general anesthesia, impacting as many as 80% of patients identified as high-risk. PONV can prolong recovery time, extend hospital stays, and result in serious complications. 5-HT3 receptor antagonists, including Ondansetron, have traditionally been considered the gold standard; however, Palonosetron, a newer agent with an extended half-life and increased receptor affinity, has been proposed as a viable alternative. This research evaluates the effectiveness of Palonosetron versus Ondansetron in preventing postoperative nausea and vomiting (PONV) in patients undergoing abdominal surgery. Aim: To assess the effectiveness of intravenous (IV) Palonosetron (0.075 mg) and IV Ondansetron (4 mg) in preventing postoperative nausea and vomiting (PONV) in patients undergoing general anesthesia for abdominal surgery. Methodology: A comparative study was undertaken at Department of Anesthesia, Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Nalanda, Bihar, India on 70 patients receiving major abdominal surgery. Patients were randomly assigned to two groups: Group P (Palonosetron, n=35) and Group O (Ondansetron, n=35). The incidence of postoperative nausea and vomiting (PONV), its severity, the requirement for rescue antiemetics, and visual analog scale (VAS) scores were evaluated over a 48-hour period. Data analysis utilized SPSS v25.0, with a significance threshold set at a p-value of less than 0.05. Results: PONV was well-controlled in both groups. Vomiting remained minimal throughout. Nausea scores were significantly higher in Group P, with p=0.001 at the 24–48 hour mark. Group O exhibited reduced PONV scores and VAS scores at the 24–48 hour interval (p=0.002). Both groups exhibited minimal consumption of rescue antiemetics. Conclusion: Ondansetron showed a slight but noteworthy benefit in reducing the intensity of nausea and the requirement for rescue medication, while Ondansetron and Palonosetron prevented PONV equally well. The longterm benefits of Palonosetron's extended half-life require further investigation in future studies.