Abstract
OBJECTIVE: The effects of prophylactic administration of preclinical palonosetron hydrochloride (PH) and dexamethasone (DXMS) on nausea and vomiting (N/V) induced by transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) were evaluated. The goal was to furnish evidence that could guide clinical nursing practices. METHODS: A retrospective analysis was conducted on 112 patients with HCC between July and December 2022. They were categorized into two groups: those administered PH only (the PH group) and those administered a combination of PH and DXMS (the PH + DXMS group). Statistical tests including χ (2), Fisher's exact test, paired t-test, and logistic regression were employed to compare the occurrence of N/V and identify associated factors. RESULTS: After TACE was administered, there was a significant increase in the occurrence of nausea (p < 0.001) and vomiting (p < 0.003) among patients in the PH group. Compared with the PH group, the frequency of nausea after TACE among patients in the PH + DXMS group was significantly reduced (67.2% vs. 37.8%, respectively; p = 0.004), and the frequency of vomiting was slightly reduced (26.9% vs. 8.9%, respectively; p = 0.060). Univariate analysis revealed that the prophylactic use of PH + DXMS prior to interventional treatment significantly reduced the days of hospitalization in patients with HCC experiencing intervention-induced nausea (p = 0.031). Logistic regression analysis revealed that the level of alanine aminotransferase (ALT) before TACE (OR = 5.833, 95% CI: 1.252-27.170, p = 0.025) was an independent factor associated with the incidence of nausea. CONCLUSION: Prophylactic administration of a combination of PH and DXMS reduced the frequency of N/V as well as the length of hospital stay in patients with HCC. Moreover, the level of ALT before TACE was identified as a predictive factor for the incidence of nausea. Further research endeavors should explore patient-specific characteristics to optimize management strategies.