A Comparative Study of Intravenous Ondansetron, Granisetron and Ramosetron for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Caesarean Section

R, Bansal Suman; Umesh, Ramtani; Rohan, Bansal

doi:10.14260/jemds/2017/123

Cited by 2 publications

(2 citation statements)

References 24 publications

(7 reference statements)

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“…Surgical procedures varied among the RCTs and included minor surgery, laparoscopic surgery, orthopedic surgery, major abdominal surgery, pulmonary lobectomy, craniotomy, and cardiac surgery. The ondansetron dose was 4 mg in 13 RCTs [ 18 , 21 , 24 , 25 , 27 , 28 , 30 – 32 , 37 , 39 , 41 , 42 ], 8 mg in five RCTs [ 19 , 22 , 33 , 36 , 40 ], both 4 mg and 8 mg in three RCTs [ 6 , 20 , 23 ], and other doses in six RCTs [ 26 , 29 , 34 , 35 , 38 , 43 ]. All RCTs used 0.3 mg of ramosetron except for four studies [ 26 , 29 , 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

Comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting: An updated systematic review and meta-analysis with trial sequential analysis

Yokoi

Mihara

et al. 2017

PLoS ONE

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BackgroundPostoperative nausea and vomiting is a distressing complication of surgery, and 5-HT3 receptor antagonists are often prescribed to prevent it. Ondansetron is the agent typically administered to prevent postoperative nausea and vomiting. Although ramosetron has a longer duration of action than ondansetron, it remains unclear whether ramosetron is the more effective medication. We performed an updated meta-analysis on the comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting.MethodsWe searched six databases for all trials that randomly assigned patients to ramosetron or ondansetron groups. The primary outcome was postoperative nausea or vomiting in the early, late, and next-day periods. The secondary outcomes were side effects of the medications. We used the random-effects model to combine the results. Trial sequential analyses were performed to correct for repetitive testing in the updated meta-analysis.ResultsTwenty-seven randomized controlled trials with 3,811 patients were included in the meta-analysis. The combined results of ramosetron vs. ondansetron efficacy in preventing postoperative nausea and vomiting were as follows: Risk ratio [95% confidence interval] = 0.82 [0.69–0.98] for early postoperative nausea, 0.76 [0.65–0.89] for late postoperative nausea, 0.69 [0.57–0.84] for next-day postoperative nausea, 0.78 [0.63–0.98] for early postoperative vomiting, 0.57 [0.45–0.72] for late postoperative vomiting, and 0.61 [0.43–0.86] for next-day postoperative vomiting. Dizziness was significantly lower in ramosetron groups than in ondansetron groups (risk ratio [95% confidence interval] = 0.81 [0.66–0.98]). Trial sequential analysis revealed that the results for late postoperative nausea, late postoperative vomiting, and next-day postoperative nausea were conclusive.ConclusionsRamosetron is more effective in preventing late postoperative nausea, late postoperative vomiting, and next-day postoperative nausea than ondansetron. The incidence of dizziness may be lower in patients receiving ramosetron than in patients receiving ondansetron.Trial registrationUniversity hospital Medical Information Network Clinical Trials Registry: UMIN000022980

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Section: Resultsmentioning

confidence: 99%

Comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting: An updated systematic review and meta-analysis with trial sequential analysis

Yokoi

Mihara

et al. 2017

PLoS ONE

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“…To determine whether the remaining 43 studies met the criteria for inclusion, their full texts were carefully analysed. Notably, 18 additional trials were omitted for the following reasons: conference abstracts (n = 3) [16][17][18] and no available outcomes (n = 15) [6,8,14,[19][20][21][22][23][24][25][26][27][28][29]. Finally, a total of 25 trials that satisfied the eligibility requirements were selected for inclusion in the metaanalysis [2,[11][12][13].…”

Section: Search Resultsmentioning

confidence: 99%

Ondansetron Reduces the Incidence of Hypotension after Spinal Anaesthesia: A Systematic Review and Meta-Analysis

et al. 2022

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Hypotension induced by spinal anaesthesia is a common clinical complication associated with multiple perioperative adverse events. We conducted a systemic review and meta-analysis to confirm whether ondansetron could alleviate hypotension following spinal anaesthesia. PubMed, Embase, Web of Science, and Cochrane Library were searched to identify eligible randomised controlled trials from their respective database inception dates to 30 September 2022. The primary outcome of the meta-analysis was the incidence of hypotension after spinal anaesthesia. The risk of bias in the included studies was evaluated using the revised Cochrane risk of bias tool for randomised trials (RoB 2.0). Grading of Recommendations, Assessment, Development, and Evaluation was applied to assess the level of certainty. A total of 25 studies were included in this research. The meta-analysis revealed that ondansetron significantly decreased the incidence of hypotension (RR = 0.65, 95% CI 0.53–0.80, p < 0.01, I2 = 64%) and bradycardia. In addition, patients treated with ondansetron had a reduced need for vasopressors administration. This study suggests that ondansetron may be recommended as a prophylaxis for hypotension and bradycardia following spinal anaesthesia; the level of evidence was moderate with a high level of heterogeneity.

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A Comparative Study of Intravenous Ondansetron, Granisetron and Ramosetron for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Caesarean Section

Cited by 2 publications

References 24 publications

Comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting: An updated systematic review and meta-analysis with trial sequential analysis

Comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting: An updated systematic review and meta-analysis with trial sequential analysis

Ondansetron Reduces the Incidence of Hypotension after Spinal Anaesthesia: A Systematic Review and Meta-Analysis

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