Journal of Anesthesia

, Volume 30, Issue 6, pp 935–940 | Cite as

A randomized, double-blind trial evaluating the efficacy of palonosetron with total intravenous anesthesia using propofol and remifentanil for the prevention of postoperative nausea and vomiting after gynecologic surgery

  • Yun-Sic Bang
  • Young Uk Kim
  • Dawoon Oh
  • Eui Yong Shin
  • Soo Kyoung ParkEmail author
Original Article



Palonosetron has potent and long-acting antiemetic effects for postoperative nausea and vomiting (PONV). The aim of this study was to prospectively evaluate the efficacy of palonosetron when used with total intravenous anesthesia (TIVA) using propofol and remifentanil for the prevention of PONV in patients undergoing laparoscopic gynecologic surgery.


This prospective double-blind study comprised 100 female American Society of Anesthesiologist physical status I and II patients who were undergoing laparoscopic gynecologic surgery under TIVA. The patients were randomly assigned to two groups—the palonosetron plus TIVA group (palonosetron 0.075 mg i.v., n = 50) and the TIVA group (normal saline 1.5 ml i.v., n = 50). The treatments were given before the induction of anesthesia. The incidence of PONV, severity, number of rescue antiemetics, adverse effects, and patient satisfaction during the first 24 h after surgery were evaluated.


The demographic profiles of the patients in the two groups were comparable. The overall incidence of PONV (0–24 h) was significantly lower in the TIVA plus palonosetron group than in the TIVA group (34 vs 58 %, p = 0.027). In particular, during the 6–24 h after surgery, the incidence of PONV (14 vs 30 %, p = 0.03) and the incidence of moderate to severe nausea (6 vs 22 %, p = 0.041) were significantly lower in the TIVA plus palonosetron group than in the TIVA group. There were no significant differences in adverse effects, use of rescue antiemetics or patient satisfaction.


Combining palonosetron with TIVA can be considered as a good method to prevent PONV, not only during the short postoperative period but also especially during the 6–24-h period after anesthesia.


Palonosetron Postoperative nausea and vomiting Total intravenous anesthesia 



YSB contributed to data collection and manuscript drafting. YUK contributed to statistical review. EYS assisted in study design. YSB, SKP and DWO helped manage and care for the patients. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

There are no financial or other relationships to disclose that might lead to a conflict of interest regarding this article.


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Copyright information

© Japanese Society of Anesthesiologists 2016

Authors and Affiliations

  • Yun-Sic Bang
    • 1
  • Young Uk Kim
    • 1
  • Dawoon Oh
    • 2
  • Eui Yong Shin
    • 2
  • Soo Kyoung Park
    • 2
    Email author
  1. 1.Department of Anesthesiology and Pain Medicine, International St. Mary’s HospitalCatholic Kwandong University College of MedicineIncheonKorea
  2. 2.Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart HospitalHallym University College of MedicineHwaseongKorea

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