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ABSTARCT: BACKGROUND: The reported incidence of postoperative nausea and vomiting (PONV) following middle ear surgery is very high. Various treatment modalities have been tried by several workers with varying results. In this randomized double blind prospective clinical study, we investigated and compared the efficacy of palonosetron and granisetron to prevent postoperative nausea and vomiting after middle ear surgery. MATERIAL AND METHODS: Sixty patients (18-65 yrs. of age) undergoing elective middle ear surgery were randomly allocated one of the two groups containing 30 patients each. Group A received granisetron 2.5mg and Group B received palonosetron 75μg intravenously as a bolus 10 min before extubation. Peri-operative anesthetic care was standardized in all patients. The efficacy of study medication was assessed in terms of Complete Response (No emesis and no rescue antiemetic), incidence of emetic episodes and the incidence nausea in the postoperative study periods at 0-3 hours, 3-12 hours, 12-24 hours and 24-48 hours. RESULT: The incidence of a complete response (No PONV, No rescue medication) during 0-3 hour in the postoperative period was 86.6% with granisetron and 93.3% with palonosetron, the incidence during 3-12 hour postoperatively was 83.3% with granisetron and 93.3% with palonosetron. The corresponding incidence in 12-24 hour was 90% with palonosetron and 80%with granisetron group. During 24-48 hours, the incidence was 63.3% and 93.3% respectively (p<0.05). The incidences of adverse effects were statistically insignificant between the groups. CONCLUSION: Prophylactic therapy with palonosetron is more effective than granisetron for long term prevention of postoperative nausea and vomiting after middle ear surgery.

A COMPARATIVE STUDY BETWEEN PALONOSETRON AND GRANISETRON TO PREVENT POSTOPERATIVE NAUSEA AND VOMITING AFTER MIDDLE EAR SURGERY