Tropisetron 5mg capsules

IntroductionSelective 5-hydroxytryptamine 3 receptor (5-HT3) antagonists are commonly used to prevent nausea and vomiting (NV) after cesarean section, but the comparative efficacy of different 5-HT3 antagonists remains unclear. This network meta-analysis aimed to determine which 5-HT3 antagonists might be the preferred choice for preventing NV in parturient scheduled for elective cesarean delivery under spinal anesthesia.Evidence acquisitionPubMed, EMBASE, Cochrane library, and Web of Science were searched for relevant randomized controlled trials (RCTs) published before August 24, 2023. Random network meta-analysis was performed using Stata 14.0 to estimate the efficacy of different 5-HT3 antagonists in preventing intra- and post-operative NV.Evidence synthesisTwenty-eight studies involving seven dosing regimens of three 5-HT3 antagonists were included. Pooled results showed that ondansetron 12 mg was superior to other six dosing regimens in the prevention of postoperative NV (PONV), PON, and POV, with the ranking probability of 80.2%, 95.8%, and 87.7%, respectively, followed by granisetron two mg. Ondansetron 4 mg might be the first choice for preventing intraoperative NV (IONV) (92.8%), with the least use of postoperative rescue antiemetics (90.6%). Granisetron 3 mg and tropisetron 2 mg might be the best options for preventing ION and IOV, respectively.ConclusionsBased on available data, ondansetron 12 mg may have the best efficacy in preventing PONV, PON, and POV. Additionally, more studies are warranted to compare the safety of ondansetron 12 mg versus granisetron two mg.

Abstract licence: CC BY-NC

BackgroundPostoperative nausea and vomiting (PONV) remain significant complications following pediatric adenotonsillectomy. Although palonosetron, a second-generation 5-HT3 receptor antagonist, has shown potential for preventing PONV, further research is needed to assess its efficacy when combined with dexamethasone in pediatric otolaryngologic procedures. This study aims to observe the efficacy of palonosetron or tropisetron combined with dexamethasone in preventing PONV in children undergoing adenotonsillectomy.MethodsWe enrolled 110 children scheduled for elective adenotonsillectomy under general anesthesia. Based on a computer-generated random number table, children were assigned in equal proportions to receive either palonosetron or tropisetron. The P-group received palonosetron (1 μg/kg, maximum 50 μg), while the T-group received tropisetron (0.1 mg/kg, maximum 2 mg) 5 min before anesthesia induction. After receiving their allocated drug, children received intravenous dexamethasone (0.15 mg/kg, maximum 5 mg) during induction. Primary outcomes included PONV incidence at 6, 24, and 48 h postoperatively. Secondary outcomes included the number of children with PONV scores of 1, 2, and 3, rescue antiemetic medication, and adverse events.ResultsA total of 110 children (aged 3–12 y, ASA physical status 1 or 2, weighted 14.3–47.3 kg) were enrolled in the study between December 2021 and July 2023. The P-group (n = 52) demonstrated significantly lower PONV incidence than the T-group (n = 51) during the 0–48 h (5.8% vs. 25.5%, p < 0.05). Notably, this difference was most pronounced during the first 24 h: 0–6 h (0% vs. 10%, p < 0.05) and 6–24 h (3.8% vs. 7.8%, p < 0.05). The difference during 24–48 h was insignificant (4% vs. 8%, p > 0.05). Transient junctional rhythm occurred in three patients receiving tropisetron, which did not affect circulation. Headache and dizziness were similar between groups within 48 h (P-group: 3.8%, T-group: 7.8%, p > 0.05).ConclusionIn pediatric adenotonsillectomy, palonosetron with dexamethasone gives better PONV prevention than tropisetron with dexamethasone, especially in the first 24 h, with comparable safety.Clinical trial registrationhttps://www.chictr.org.cn/showproj.html?proj=127115, ChiCTR2100046848.

Abstract licence: CC BY 4.0