Ramosetron versus ondansetron for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy.
BACKGROUND
Patients undergoing general anesthesia for laparoscopic cholecystectomy are at high risk for postoperative nausea and vomiting (PONV). This study compared ramosetron and ondansetron in terms of efficacy for PONV prevention after laparoscopic cholecystectomy.


METHODS
For this study, 120 patients scheduled to undergo laparoscopic cholecystectomy were randomized (in double-blind fashion) to receive 4 mg of ondansetron (group O4, n = 40), 8 mg of ondansetron (group O8, n = 40), or 0.3 mg of ramosetron (group R, n = 40) intravenously after surgery. Postoperative nausea, retching, vomiting, pain, and side effects were assessed at 2 h, 24 h, and 48 h after surgery.


RESULTS
No statistical differences were observed among the three groups with regard to patient characteristics and information on surgery and anesthesia. The ratio of complete response (no PONV for 2 h) was higher for groups O8 and R than for group O4 as follows: 80% (n = 32) for groups O8 and R versus 58% (n = 23) for group O4 during the first postoperative 2 h (p = 0.04), 90% (n = 36) for groups O8 and R versus 76% (n = 30) for group O4 over 24 h (2-24 h) (p = 0.09), and 98% (n = 38) for groups O4 and O8 versus 100% (n = 40) for group R over the next 24 h (24-48 h) after surgery (p = 0.36). During the first 2 h after surgery, rescue antiemetics were used for significantly fewer patients in groups O8 and R (20%) than in group O4 (42.5%) (p = 0.04). Postoperative pain and the use of rescue analgesics were comparable among the groups. There was no clinically serious adverse event due to the study drugs.


CONCLUSIONS
Ramosetron 0.3 mg and ondansetron 8 mg are more effective than ondansetron 4 mg for the prevention of PONV (2 h). Ramosetron 0.3 mg is as effective as ondansetron 8 mg for the prophylaxis of PONV after laparoscopic cholecystectomy.
Ryu
Junghee
J
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166 Kumi-ro, Bundang-gu, Seongnam-si, Kyonggi-do, 463-707, South Korea.
So
Yun-Mi
YM
Hwang
Jungwon
J
Do
Sang-Hwan
SH
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000932:Antiemetics / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017294:Ondansetron / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D016896:Treatment Outcome
D000932:Antiemetics; D001562:Benzimidazoles; D017294:Ondansetron; C071315:ramosetron
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