title: Comparison of the antiemetic effect of ramosetron with the combination of dexamethasone and ondansetron in middle ear surgery: A double-blind, randomized clinical study.
abstract: BACKGROUND
  Postoperative nausea and vomiting (PONV) is a frequent complication of middle ear surgery. Ondansetron has been shown to be effective for early PONV and dexamethasone has been shown to be effective for late PONV. Therefore, a combination of dexamethasone and ondansetron is commonly used for middle ear surgery. This study was conducted to compare the combination of ondansetron and dexamethasone with ramosetron for early and late PONV up to 48 h after middle ear surgery.
  
  
  METHODS
  One hundred and twenty adults scheduled for middle ear surgery were allocated to receive either dexamethasone 8 mg and ondansetron 4 mg (n=60) or ramosetron 0.3 mg (n=60). General anesthesia with inhalation agents was used for all the patients. The incidence and severity of PONV, administration of rescue antiemetic, and the side effects of the antiemetic were documented during the first 48 h after surgery.
  
  
  RESULTS
  The incidence of nausea was significantly lower in the dexamethasone and ondansetron group compared to the ramosetron group between 2 and 24 h. The complete response, which is patients with no nausea or vomiting, was significantly more in dexamethasone and ondansetron group compared to ramosetron group between 2 and 24 h and between 24 and 48 h (76% vs. 56%, P=0.02, 93% vs. 81%, P=0.05, respectively). Overall, complete response was more in dexamethasone and ondansetron group compared to ramosetron group (71% vs. 40%, P=0.01).
  
  
  CONCLUSIONS
  The combination of dexamethasone and ondansetron is superior to ramosetron for prevention of PONV after middle ear surgeries.
authors.affiliation: Department of Anaesthesiology, SDM College of Medical Sciences and Hospital, Dharwar, Karnataka, India.
authors.forename: Sameer
authors.initials: S
authors.lastname: Desai
authors.forename: M C B
authors.initials: MC
authors.lastname: Santosh
authors.forename: Rashmi
authors.initials: R
authors.lastname: Annigeri
authors.forename: V B
authors.initials: VB
authors.lastname: Santoshi
authors.forename: Raghavendra
authors.initials: R
authors.lastname: Rao
keywords: Dexamethasone; middle ear surgery; ondansetron; postoperative nausea and vomiting; ramosetron