
With the change in the emphasis from an inpatient to outpatient, hospital and office-based medical/surgical enhancement, there has been increased interest in the ‘big little problem’ of PONV, one of the main complaints in patients undergoing surgery under general anaesthesia. It is one of the most important factors that determine the length of hospital stay after ambulatory anaesthesia, can delay discharge and result in unplanned overnight hospital admission. This high incidence may justify the use of prophylactic antiemetic therapy and among them,the 5 HT3 antagonists are very effective in preventing post-operative nausea and vomiting and do not produce any significant side effects. This randomized, open study compares the efficacy of Ondansetron and Palonosetron in the prevention of post – operative nausea and vomiting. The incidence of PONV was significantly less in the Palonosetron group (5.55%) as compared to the Ondansetron group (43.33%), with a lesser need for rescue antiemetic in the Palonosetron group (10% vs. 53%). Though the side effects of Ondansetron and Palonosetron are comparable, Palonosetron is one of the most effective anti-emetic drug used for prevention of PONV in ENT surgeries.