Comparison of palonosetron, granisetron, and ramosetron for the prevention of postoperative nausea and vomiting after laparoscopic gynecologic surgery: a prospective randomized trial

Abstract

BackgroundSelective 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists are reported to have potent antiemetic effects for postoperative nausea and vomiting (PONV). The purpose of this study was to prospectively evaluate the efficacy of palonosetron, granisetron, and ramosetron for the prevention of PONV in patients undergoing laparoscopic gynecologic surgery.MethodsIn this prospective, randomized observational study, 105 healthy female patients who were undergoing laparocopic hystectomy under general anaesthesia were enrolled (clinical trial number: NCT01752374, www.clinicaltrials.gov). Patients were divided into three groups: the palonostron (0.075 mg i.v.; n = 35), the granisetron group (3 mg i.v.; n = 35), and the ramosetron group (0.3 mg i.v.; n = 35). The treatments were given before the end of surgery. The incidence of PONV, severity of nausea/vomiting, and the use of rescue antiemetic requirements during the first 48 h after surgery were evaluated.ResultsThe overall incidence of PONV was 33.3 % for this series. The number of complete responders at 48 h after the surgery was 21 (60.0 %) for palonosetron, 24 (68.6 %) for granisetron, and 26 (71.4 %) for ramosetron, representing no statistical difference (P = 0.086).ConclusionsThere were no significant differences in the overall incidence of postoperative nausea and vomiting and complete responders for palonosetron, granisetron and ramosetron group.Trial registrationClinical trial number: NCT01752374, www.clinicaltrials.gov.

Palonosetron and Ramosetron Compared for Effectiveness in Preventing Postoperative Nausea and Vomiting: A Systematic Review and Meta-Analysis

“…The 5-HT 3 antagonists (palonosetron and ramosetron) were administrated during the early phase of the operation in four studies [14–16,19] and at the end of the surgery in four [17,18,20,21]. …”

“…Six studies [14–16,18–20] compared the effectiveness of palonosetron to that of ramosetron in the prevention of early PON. Five studies [15,16,18–20] compared late PON, and six studies [14–16,18–20] compared the effectiveness of the drugs on overall PON.…”

“…Five studies [15,16,18–20] compared late PON, and six studies [14–16,18–20] compared the effectiveness of the drugs on overall PON. There were no significant differences between palonosetron and ramosetron in the incidence of early PON (RR 0.92; 95% CI, 0.54 to1.58; P chi 2 = 0.06; I 2 = 53.1%; Number needed to treat harm(NNTH) 240.8; 95% CI, NNTH 13.4 to ∞ to Number needed to treat benefit (NNTB) 15.2), late PON (RR 0.87; 95% CI, 0.48 to 1.57; P chi 2 = 0.061; I 2 = 55.5%; NNTB 57.3; 95% CI, NNTH 19.7 to ∞ to NNTB 11.7), or overall PON between palonosetron and ramosetron (RR 0.92; 95% CI, 0.54 to1.58; P chi 2 = 0.06; I 2 = 53.1%; NNTH 240.8; 95% CI, NNTH 13.4 to ∞ to NNTB 15.2).…”

A Comparative Study of Granisetron, Ramosetron and Palonosetron as Antiemetics in Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Surgeries

“…Our results were similar to study conducted by Lee WS et al, who found that there were no significant differences in the overall incidence of postoperative nausea and vomiting and complete responders for Palonosetron, Granisetron and Ramosetron group. [25] The percentage of patients who had nausea between 4-12 hours of the study period was 20.00% with Granisetron, 13.33% with Ramosetron and 6.67% with Palonosetron. Similarly, the percentage of patients who had nausea between 12-24 hours of the study period was 16.67% with Granisetron, 10.00% with Ramosetron and 6.67% with Palonosetron.…”

Efficacy, Safety and Quality of Life Outcomes of Palonosetron, Ramosetron and Granisetron as a Part of Antiemetic Therapy in Prevention of Chemotherapy Induced Nausea and Vomiting- A Randomised Comparative Trial

“…15 In a comparative study of antiemetics for the prevention of postoperative nausea and vomiting after laparoscopic gynaecologic surgery, the number of complete responders at 48 h after the surgery was maximum for ramosetron, though the differences between the groups were not statistically significant. 16 In all the three groups, the complete response rates in the acute phase were seen to be better as compared to the respective complete response rates in the delayed phase in the terms of proportions. In a phase II trial of ramosetron and dexamethasone in the prevention of cisplatin-induced nausea and vomiting, the prevention of acute emesis seemed to be more effective than the prevention of delayed emesis.…”