Single-dose i.v. granisetron in the 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.

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Single-Dose Intraoperative Steroid Administration Does Not Impact Early Atrial Fibrillation Recurrence

10.21203/rs.3.rs-672135/v1 ◽

2021 ◽

Author(s):

Kolade M. Agboola ◽

Michael Dietrich ◽

Roshan Karki ◽

Fahad Lodhi ◽

Trevon McGill ◽

...

Keyword(s):

Single Dose ◽

Catheter Ablation ◽

Postoperative Nausea ◽

Group Versus ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Cardiac Monitoring ◽

P Value ◽

Dexamethasone Group ◽

Af Recurrence

Abstract Purpose: To evaluate the effect of single-dose intravenous dexamethasone on AF recurrence following radiofrequency catheter ablation. Methods: A cohort of 94 adult patients (>18 years) underwent catheter ablation at Mayo Clinic Rochester from January to March 2019. Only first-time ablation patients were included, with all re-do ablations excluded to minimize heterogeneity. Administration of intraoperative dexamethasone 4 mg or 8 mg was determined by chart review from the procedure. At our institution, intraoperative intravenous steroids are administered for postoperative nausea and vomiting (PONV) prophylaxis at the discretion of the anesthesiologist. AF recurrence was determined by ECG or cardiac monitoring at less than 3 months or between 3 months and 1 year with an in-person follow-up visit. Results: A total of 36.2% of patients received intravenous dexamethasone compared to 63.8% who did not (providing a 2:1 comparison group). The incidence of documented AF or flutter lasting greater than 30 seconds was 20.6% in the dexamethasone group versus 21.7% in the non-dexamethasone group, p value 1.00. AF or atrial flutter recurrence from 3 months to 1 year was 20.6% in the dexamethasone group compared to 21.7% in the non-dexamethasone group, p value 1.00. Conclusion: These data suggest that intraoperative intravenous dexamethasone administered during AF ablation for postoperative nausea and vomiting prophylaxis does not have a significant effect on AF recurrence rates.

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