title: Prophylactic control of post-operative nausea and vomiting using ondansetron and ramosetron after cardiac surgery.
abstract: BACKGROUND
  The aim of this study was to evaluate the efficacy of ondansetron and ramosetron in the reduction of post-operative nausea and vomiting (PONV) associated with patient-controlled analgesia (PCA) after cardiac surgery.
  
  
  METHODS
  A total of 320 patients scheduled for elective cardiac surgery were enrolled. Patients were randomly assigned to one of four treatment regimens (n=80 in each group): no prophylactic antiemetics (group P); intravenous (i.v.) ondansetron 4 mg at the end of surgery and 12 mg added to PCA (group O); i.v. ramosetron 0.3 mg at the end of surgery and no antiemetics added to PCA (group R1); and i.v. ramosetron 0.3 mg at the end of surgery and 0.6 mg added to PCA (group R2).
  
  
  RESULTS
  The incidence of PONV during the 48-h post-operative period was lower in groups O (46%), R1 (54%), and R2 (35%) compared with group P (71%, P<0.001). The incidence and severity of nausea were lower in groups O, R1, and R2 than in group P during the 24-h post-operative period, whereas the incidence and severity of nausea during 24-48 h after surgery were lower in groups O and R2, but not in group R1, than in group P. Compared with group P (53%), the frequency of rescue antiemetic usage was significantly lower in groups O (34%) and R2 (29%), but not in group R1 (43%).
  
  
  CONCLUSIONS
  The addition of either ondansetron or ramosetron to PCA can reduce the incidence of PONV during 48 h after cardiac surgery.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
authors.forename: D K
authors.initials: DK
authors.lastname: Choi
authors.forename: J H
authors.initials: JH
authors.lastname: Chin
authors.forename: E H
authors.initials: EH
authors.lastname: Lee
authors.forename: O B
authors.initials: OB
authors.lastname: Lim
authors.forename: C H
authors.initials: CH
authors.lastname: Chung
authors.forename: Y J
authors.initials: YJ
authors.lastname: Ro
authors.forename: I C
authors.initials: IC
authors.lastname: Choi
mesh_terms: D000368:Aged; D016058:Analgesia, Patient-Controlled; D000758:Anesthesia; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D017294:Ondansetron / Q000008:administration & dosage / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000453:epidemiology; D011182:Postoperative Care; D020250:Postoperative Nausea and Vomiting / Q000175:diagnosis / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D001562:Benzimidazoles; D017294:Ondansetron; C071315:ramosetron