title: Ramosetron vs. ramosetron plus dexamethasone for the prevention of postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy: prospective, randomized, and double-blind study.
abstract: BACKGROUND
  Up to 75% of the patients undergoing laparoscopic cholecystectomy develop postoperative nausea and vomiting (PONV). Both ramosetron, a serotonin subtype 3 (5-HT3) antagonist, and dexamethasone are effective for PONV prophylaxis following laparoscopic cholecystectomy but their combined effect has not been investigated. We investigated the efficacy and tolerance of ramosetron alone and ramosetron with dexamethasone for PONV prophylaxis after laparoscopic cholecystectomy.
  
  
  METHODS
  Seventy six patients scheduled for laparoscopic cholecystectomy were randomized to receive either intravenous (i.v.) 0.3 mg ramosetron (group R), or 8 mg dexamethasone plus 0.3 mg ramosetron (group D). Standardized anesthesia with desflurane and remifentanil was used in all patients. Postoperative nausea, retching, vomiting, rescue antiemetics, pain scores, rescue analgesics and side effects were assessed at 0-2, 2-24 and 24-48 h postoperatively.
  
  
  RESULTS
  Seventy two patients were randomized. The overall incidence of PONV did not differ (p = 0.31) but fewer patients needed rescue antiemetics in group D than in groups R (3 vs. 13 patients, respectively; p = 0.01) during 0-48 h postoperatively. Additionally, pain scores were significantly lower in group D during the study period (p < 0.01) and rescue analgesics were required less often in group D during 2-48 h postoperatively (p < 0.01).
  
  
  CONCLUSIONS
  In patients undergoing laparoscopic cholecystectomy, the combined use of ramosetron and dexamethasone was more effective than ramosetron alone for reducing the need for rescue antiemetics and pain control following the procedure.
authors: Department of Anesthesiology & Pain Medicine, Seoul National University Bundang Hospital, 166 Kumi-ro, Bundang-gu, Seongnam-si, Kyonggi-do 463-707, Republic of Korea.
authors: Jung-Hee
authors: JH
authors: Ryu
authors: Ji-Eun
authors: JE
authors: Chang
authors: Hye-Rim
authors: HR
authors: Kim
authors: Jung-Won
authors: JW
authors: Hwang
authors: Ah-Young
authors: AY
authors: Oh
authors: Sang-Hwan
authors: SH
authors: Do
mesh_terms: D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000517:prevention & control*; D011446:Prospective Studies
chemical_list: D000932:Antiemetics; D001562:Benzimidazoles; D003907:Dexamethasone; C071315:ramosetron