COMPARATIVE STUDY BETWEEN PALONOSETRON AND FOSAPREPITANT IN THE PROFILAXIA OF POSTOPERATIVE NAUSEA AND VOMITING IN WOMEN SUBMITTED TO VIDEOLAPAROSCOPIC COLECISTECTOMIES

The prospective, randomized and double-blind clinical trial will be performed at the Federal Hospital of Bonsucesso (HFB), Rio de Janeiro, RJ.

The Informed Consent Form (TCLE) will be presented and signed, on an outpatient basis, by each of the volunteer participants, who will be guided about the risks and benefits of the research, according to resolution CNS 466/12. A total of 100 female patients, aged between 18 and 60 years, ASA I and II, submitted to elective laparoscopic cholecystectomies, were randomly assigned to two groups: Group P (GP) will receive palonosetron 75 mcg and the other Group F GF), you will receive fosaprepitanto 150 mg. Palonosetron and fosaprepitanto are not standard medications in HFB. Both will be purchased and will be in the possession of the principal investigator, who undertakes to obey the current norms of the hospital institution and ensure the quality, storage and adequate stability of medications.

Patients will not receive preanesthetic medication. They will be monitored in the operating room with noninvasive blood pressure, electrocardioscopy, pulse oximetry, capnography, capnometry and bispectral index (BIS).

Patients will have a cannulated peripheral vein, be pre-oxygenated with oxygen at 100% for 5 minutes and anesthetic induction will be performed with intravenous administration (e.v.) of fentanyl 3 mcg / kg; lidocaine 1.5 mg / kg and propofol 2 mg / kg. Tracheal intubation will be facilitated after 3 minutes of administration of rocuronium 0.6 mg / kg e.v. After induction of anesthesia, the antiemetics, depending on the group studied, will be administered e.v. in solution containing 100 ml of 0.9% strength.

Maintenance of anesthesia will be with sevoflurane 2 L / min in 50% oxygen / air, with its concentration adjusted to maintain BIS between 40-60. Remifentanil 0.05 mcg / kg / min at 0.2 mcg / kg / min via e.v. may be given intraoperatively if the heart rate or blood pressure rises by more than 20% of the baseline values. Additional doses of rocuronium may also be given as needed. Patients will receive paracoxib 40 mg, dipyrone 50 mg / kg and ranitidine 50 mg e.v. after tracheal intubation. The surgical wound will be infiltrated with 20 ml of 0.5% ropivacaine before the sutures. The neuromuscular blockade will be reversed with neostigmine 0.04 mg / kg and atropine 0.02 mg / kg per e.v. Morphine 0.03 mg / kg e.v. will be given at the end of the surgery. The inflation of the pneumoperitoneum with CO2 (carbon dioxide), will have as limit abdominal pressure of 15 mmHg.