COMPARATIVE EFFICACY OF PALONOSETRON–DEXAMETHASONE AND ONDANSETRON–DEXAMETHASONE IN LAPAROSCOPIC CHOLECYSTECTOMY: INSIGHTS FROM CLINICAL STUDIES

Abstract

Post operative nausea and vomiting is a frequent, unproductive complications of laparoscopic cholecystectomy, which leads to delayed recovery, unexpected hospital admissions, and higher healthcare expenses. Prophylaxis is critical, especially when it comes to high-risk patients detected through the use of risk stratification instruments. The study is a synthesis of available evidence comparing palonosetron-dexamethasone and ondansetron-dexamethasone combinations in the prevention of postoperative nausea and vomiting. In randomized controlled trials and comparative studies, both regimens are highly effective in the immediate postoperative period, but palonosetron has more effective control in the late postoperative period because of its longer half-life and longer receptor occupancy. The combination also minimises the use of rescue antiemetics and results in more patient satisfaction scores, with no augmentation of the cases of adverse effects. The results favour the utilisation of palonosetron with dexamethasone as a component of a multimodal prophylaxis approach, especially in patients undergoing laparoscopic surgery and who have several risk factors for emesis. The wider implementation of such a regimen could lead to improved recovery (omit measures), pre-emption of discharge, and better perioperative measures.