European Journal of Cardiovascular Medicine

Background: Postoperative nausea and vomiting (PONV) is a common complication following surgical procedures, impacting patient recovery and satisfaction. This clinical trial aimed to compare the efficacy of palonosetron and ondansetron for PONV prevention, considering their safety profiles, patient satisfaction, and perioperative outcomes. Methods: A prospective, randomized, double-blind, controlled clinical trial enrolled patients undergoing elective surgery under general anesthesia. Patients were assigned to receive either palonosetron or ondansetron. The primary outcome was the incidence of PONV within 24 hours postoperatively. Secondary outcomes included time to first nausea and vomiting, adverse events, patient satisfaction, postoperative pain scores, and time to ambulation. Statistical analyses were employed to assess the differences between treatment groups. Results: Among the 300 patients (150 per group), palonosetron demonstrated a significantly lower incidence of PONV within 24 hours compared to ondansetron (10.7% vs. 24.0%, p < 0.001). The palonosetron group exhibited a prolonged time to first nausea and vomiting (p < 0.001 for both). Adverse events were comparable between groups, and patient satisfaction scores trended higher with palonosetron. Postoperative pain scores were lower (p = 0.013) and time to ambulation was shorter (p = 0.029) in the palonosetron group. Conclusion: This clinical trial highlights the superior efficacy of palonosetron over ondansetron in preventing PONV during the immediate postoperative period. Palonosetron's extended antiemetic effect, coupled with favorable safety and patient-centered outcomes, underscores its potential as a preferred antiemetic choice. These findings contribute to evidence-based perioperative practices, enhancing patient care and recovery.