To Evaluate the Efficacy and Safety of Ondansetron Versus Palonosetron in Prevention of Nausea and Vomiting After Laparoscopic Appendicectomy - A Randomized, Prospective, Double Blind, Comparative Study

Dr. Kalpesh Patil ^1*, Dr. Vivek Kantariya ², Dr. Sara Mary Thomas ³, Dr. Tejash H. Sharma ⁴

¹Associate Professor, Department of Anaesthesiology, Dhiraj Hospital, Smt. B.K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Piparia, Vadodara, Gujarat, India.

²Chief District Medical Officer cum Civil Surgeon, Jamnabai General Hospital, Vadodara, Gujarat, India.

³Professor and Head, Department of Anaesthesiology, Dhiraj Hospital, Smt. B.K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Piparia, Vadodara, Gujarat, India.

⁴Professor, Department of Anaesthesiology, Dhiraj Hospital, Smt. B.K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Piparia, Vadodara, Gujarat, India.

*Corresponding Author: Dr. Kalpesh Patil, Associate Professor, Department of Anaesthesiology, Dhiraj Hospital, Smt. B.K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Piparia, Vadodara, Gujarat, India.

Received: 18th Dec, 2025; Revised: 18th Feb 2026; Accepted: 20th Feb, 2026; Available Online: 28th Feb, 2026

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ABSTRACT

Background: Postoperative nausea and vomiting remain common complications after laparoscopic appendicectomy despite advancements in anaesthetic practice. Newer 5-HT3 antagonists such as palonosetron may provide prolonged antiemetic protection compared with ondansetron.

Aim: To evaluate and compare the efficacy and safety of intravenous ondansetron 4 mg and palonosetron 0.075 mg administered before induction of general anaesthesia in preventing postoperative nausea and vomiting.

Methods: A prospective randomized double-blind study was conducted in 150 female patients undergoing elective laparoscopic appendicectomy. Patients were divided into two equal groups receiving ondansetron or palonosetron. Incidence and severity of nausea, vomiting, complete response rates, rescue antiemetic use and adverse drug reactions were recorded for 72 hours postoperatively.

Results: Both drugs significantly reduced postoperative emesis; however, palonosetron demonstrated lower incidence and severity of nausea, particularly during the 4–24 hour postoperative period. Complete response rates were higher in the palonosetron group, and adverse effects were mild and comparable between groups.

Conclusion: Palonosetron provides superior control of postoperative nausea with comparable safety to ondansetron and may be preferred for prophylaxis in high-risk laparoscopic surgery patients.

Keywords: Postoperative nausea and vomiting, Ondansetron, Palonosetron, Laparoscopic appendicectomy.

How to cite this article: Patil K, Kantariya V, Thomas SM, Sharma TH. To evaluate the efficacy and safety of ondansetron versus palonosetron in prevention of nausea and vomiting after laparoscopic appendicectomy - a randomized, prospective, double blind, comparative study. Int J Drug Deliv Technol. 2026;16(5s): 385-390; DOI: 10.25258/ijddt.16.5s.52

Source of support: Nil.

Conflict of interest: None