Efficacy of Intravenous (IV) Palo With IV Dexamethasone Versus IV Palo for Prevention of Immediate and Delayed Post-Operative Nausea/Vomiting (PONV)

Inclusion Criteria:

• Has signed an informed consent form
• Have an ASA Physical Status Classification of I, II, or III

• Female, 18-55 years old

  • surgically sterilized, or
  • pre-menopausal, with a negative pregnancy test within 7 days before study medication administration
• Male, 18-55 years old, who has more than 3 risk factors for PONV
• Undergoing outpatient laparoscopic gynecological surgery or laparoscopic abdominal surgery, scheduled for between 1 and 3 hours duration
• Known to have a history of post-operative nausea and vomiting and/or a history of motion sickness
• Has been a non-smoker for at least the previous 12 consecutive months
• Is able and willing to complete a subject diary until the end of the 96 Hour Follow-Up Assessment period
• Will be available to respond to follow-up by study personnel at 72 and 96 hours post emergence from anesthesia

Exclusion Criteria:

• Has an ASA Physical Status Classification of IV or V
• Is pregnant or breastfeeding
• Has been taking more than 10-15mg of oxycodone, or an equivalent opioid dose, on a regular, daily basis, for more than 3 consecutive days before surgery
• Has received an investigational drug in the precious 30 days or who is schedule to receive any investigational drug during the study period
• Has persistent or recurrent nausea and/or vomiting due to other etiologies, including but not limited to, gastric outlet obstruction, hypercalcemia, active peptic ulcer, increased intracranial pressure, or brain metastases
• Experienced retching or vomiting or uncontrolled nausea within 48 hours before administration of study drug

• Received medication with known or potential antiemetic activity within 24 hours before receiving study drug. This includes, but is not limited to: phenothiazines, butyrophenones, hydroxyzine, lorazepam, cannabinoids, metoclopramide, corticosteroids (with the exception of topical steroids for skin disorder and inhaled steroids for respiratory disorders), trimethobenzamide, monoamine oxidase inhibitors, lithium, and 5-HT3 receptor antagonists. Subjects who might require one or more of these medications during the 24-hour treatment period, other than as described in this protocol, are also excluded.

  • Note: benzodiazepines other than lorazepam are allowed within 24 hours before and during study period, but only when used for indications such as anxiety or to induce sleep.
• Received radiation therapy to abdomen or pelvis in the 7 days prior to receiving study medication and/or will receive radiation therapy to abdomen or pelvis in the evaluation period.
• Has a history of poorly controlled diabetes mellitus
• Has a history of wound dehiscence
• Has had an incidence of necrotizing fasciitis, or any similar infectious process, within the previous 90 days
• Has a know systemic fungal infection, history of tuberculosis, or other mycobacterial infection
• Is immunocompromised - defined as a WBC count of <3,000 mm3
• Has any current or past medical condition (e.g., vagotomy) and/or require medication to treat a condition that could confound the evaluation of the data collected in this clinical trail
• Has a known hypersensitivity or contraindication to palonosetron hydrochloride or any another 5-HT3 receptor antagonist, dexamethasone, or any scheduled anesthetic or analgesic agents
• Has a known hypersensitivity to fentanyl and/or ketorolac tromethamine