Objectives: Post-operative nausea and vomiting (PONV) is a frequently experienced complication following laparoscopic cholecystectomy. This study was planned to compare the antiemetic efficacy of palonosetron with ondansetron in patients undergoing laparoscopic cholecystectomy. Methods:A total of 100 patients undergoing laparoscopic cholecystectomy were randomized into two groups. Group O (n=50) received ondansetron (8 mg) and Group P (n=50) received palonosetron (0.075 mg) 3 min before induction of anesthesia. Post-operatively, patients were assessed for the occurrence of nausea, retching, or vomiting at 0-2, 2-6, 6-24, 0-24, and 24-48 h time intervals. The overall incidence of PONV in time frame (0-48 h) was determined. The need of rescue antiemetic, side effect profile, and patient satisfaction scores were also assessed. Results:The incidence and severity of nausea at all the time intervals were comparable in the two groups. The incidence of vomiting was significantly less in Group P as compared to Group O in 0-2 h (2% vs. 14%, p=0.027) and 0-24 h time intervals (10% vs. 30%, p=0.012). The overall incidence of PONV in 0-48h was lesser in Group P as compared to Group O (28% vs. 50%, p=0.024). Rescue antiemetic was required in greater number of patients in Group O as compared to Group P (p=0.038). Side effect profile and patient satisfaction scores were comparable in the two groups. Conclusion:Palonosetron is better than ondansetron in lowering the overall incidence of PONV in 0-48 h time interval, in patients undergoing laparoscopic cholecystectomy.

Fig. 2. (a) IV cannula with displaced elastomeric sleeve and reduced space between sleeve's proximal end and connector of IV infusion set (b) IV cannula with correctly positioned elastomeric sleeve (c) displaced elastomeric sleeve covering the injection port partially.