title: Ramosetron, midazolam, and combination of ramosetron and midazolam for prevention of postoperative nausea and vomiting: a prospective, randomized, double-blind study.
abstract: OBJECTIVE
  To compare the efficacy of ramosetron, midazolam, and the combination of ramosetron and midazolam in the prevention of postoperative nausea and vomiting (PONV) in female patients undergoing thyroidectomy.
  
  
  METHODS
  Patients were randomized to receive 0.3 mg ramosetron (Group R), 75 µg/kg midazolam (Group M) or 0.3 mg ramosetron combined with 75 µg/kg midazolam (Group RM) before the induction of anaesthesia. PONV, use of rescue antiemetics, pain severity and fentanyl consumption were assessed for 24 h after thyroidectomy.
  
  
  RESULTS
  A total of 100 patients were enrolled; 94 patients completed the study. The severity of nausea was statistically significantly reduced at 0-2 h in Group RM compared with Groups R and M, and at 2-6 h in Group RM compared with Group M. The incidence of retching and vomiting was significantly lower at 0-2 h, 2-6 h, 6-12 h in Group RM than in Group M, and lower in Group R than Group M at 6-12 h. The requirement for rescue antiemetics was significantly lower at 0-2 h in group RM than in group M.
  
  
  CONCLUSIONS
  The combination therapy of ramosetron and midazolam provided superior antiemetic efficacy compared with midazolam single therapy, but did not show any significant additional benefits compared with ramosetron single therapy.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
authors.forename: Won Joong
authors.initials: WJ
authors.lastname: Kim
authors.forename: Hyun
authors.initials: H
authors.lastname: Kang
authors.forename: Hwa Yong
authors.initials: HY
authors.lastname: Shin
authors.forename: Chong Wha
authors.initials: CW
authors.lastname: Baek
authors.forename: Yong Hun
authors.initials: YH
authors.lastname: Jung
authors.forename: Young Cheol
authors.initials: YC
authors.lastname: Woo
authors.forename: Jin Yun
authors.initials: JY
authors.lastname: Kim
authors.forename: Gil Hoi
authors.initials: GH
authors.lastname: Koo
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects; D000932:Antiemetics / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006801:Humans; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000517:prevention & control*; D011446:Prospective Studies; D013965:Thyroidectomy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000932:Antiemetics; D001562:Benzimidazoles; C071315:ramosetron; D008874:Midazolam; D005283:Fentanyl
keywords: Midazolam; PONV; postoperative nausea and vomiting; ramosetron; thyroidectomy