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Efficacy of palonosetron in comparison with other 5-HT3 antagonist drugs in preventing postoperative nausea and vomiting after otorhinolaryngological surgeries: A meta-analysis

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Meta-analysis

Author Details : S Parthasarathy, R Sripriya, S Kulandayyan, S Balachandar*

Volume : 12, Issue : 1, Year : 2025

Article Page : 4-14

https://doi.org/10.18231/j.ijca.2025.002

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Abstract

Palonosetron, a 5-HT3 receptor blocker, is known to be more effective and longer-lasting in preventing postoperative nausea and vomiting (PONV). This study aimed to compare the efficacy of palonosetron with other drugs in preventing PONV after otorhinolaryngological surgeries.A systematic search of randomized clinical trials was conducted using various databases such as Google Scholar, Science Direct, Embase, and PubMed. Nine clinical trials from eight studies were included in this meta-analysis. Data were extracted for early (0-24 hours) and delayed (24-48 hours) PONV. Revman 5.4 software was used for statistical analysis, and a random-effects model was applied due to heterogeneity exceeding 50%.The present meta-analysis results revealed that Palonosetron was more effective than other drugs, such as Ondansetron, Dexamethasone, and Tropisetron, in both the early (0-24 hours) and delayed (24-48 hours) phases of PONV prevention after otorhinolaryngological surgeries. In the early phase, Palonosetron demonstrated a significantly lower incidence of nausea and vomiting compared to other drugs. Similarly, in the delayed phase, Palonosetron maintained its superior antiemetic efficacy, reducing the occurrence of PONV more effectively than the other agents. The analysis also showed that when these other drugs were combined, their overall effect was not as effective as Palonosetron alone in both early and delayed PONV prevention. The forest plot indicated a significant difference in favour of Palonosetron, with consistent results across multiple studies despite the heterogeneity observed. This suggests that Palonosetron provides a more sustained and reliable reduction in PONV, making it a more effective choice for patients undergoing otorhinolaryngological surgeries.Our study concluded that palonosetron is more efficient than Ondansetron, Dexamethasone, and Tropisetron in preventing postoperative nausea and vomiting after otorhinolaryngological surgeries.
 

Keywords: Postoperative nausea and vomiting, Palonosetron, 5- HT3 antagonist, Otorhinolaryngological surgeries, Meta- analysis.

How to cite : Parthasarathy S, Sripriya R, Kulandayyan S, Balachandar S, Efficacy of palonosetron in comparison with other 5-HT3 antagonist drugs in preventing postoperative nausea and vomiting after otorhinolaryngological surgeries: A meta-analysis. Indian J Clin Anaesth 2025;12(1):4-14

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