Efficacy of Palonosetron Plus Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Gynaecological Laparoscopic Surgery

Overview

Postoperative nausea and vomiting (PONV) is a common complication after general anaesthesia, especially among female patients undergoing laparoscopic surgery. This randomized controlled trial evaluates whether combined palonosetron and dexamethasone is more effective than palonosetron alone in preventing postoperative nausea and vomiting after gynaecological laparoscopic surgery. Eligible patients will be randomized into two parallel groups. The intervention group will receive palonosetron plus dexamethasone, while the comparator group will receive palonosetron alone. Patients will be followed for 24 hours after surgery for incidence and severity of nausea and vomiting, rescue antiemetic requirement, adverse effects, patient satisfaction, and haemodynamic parameters.

Postoperative nausea and vomiting (PONV) is a common and distressing complication following general anaesthesia, particularly among female patients undergoing laparoscopic surgical procedures. Although several medications are available for prevention of PONV, no single agent completely eliminates the risk because multiple physiological and surgical factors contribute to its development. Palonosetron is a second-generation serotonin (5-hydroxytryptamine-3 or 5-HT3) receptor antagonist with a prolonged duration of action and strong receptor affinity. It reduces nausea and vomiting by blocking serotonin-mediated pathways involved in the vomiting reflex. Dexamethasone, a corticosteroid with antiemetic properties, has also been shown to enhance the effectiveness of other antiemetic medications through multiple mechanisms, including modulation of inflammatory pathways and enhancement of antiemetic receptor sensitivity. This randomized controlled trial is designed to evaluate whether adding dexamethasone to palonosetron provides improved prevention of postoperative nausea and vomiting compared with palonosetron alone in patients undergoing gynaecological laparoscopic surgery under general anaesthesia. Participants will be randomly assigned to receive either combined palonosetron and dexamethasone or palonosetron alone before induction of anaesthesia. All participants will undergo standardized anaesthetic management and postoperative monitoring. The study will assess the effectiveness and safety of these preventive strategies during the postoperative period. The findings of this study may provide additional evidence regarding the role of combination antiemetic therapy in improving postoperative recovery, patient comfort, and satisfaction after laparoscopic gynaecological procedures. The results may contribute to optimizing perioperative care practices and improving the management of patients at risk of postoperative nausea and vomiting.