Prophylactic control of post‐operative nausea and vomiting using ondansetron and ramosetron after cardiac surgery

Choi, Dae Ki; Chin, Ji Hyun; Lee, Eun‐Ho; Lim, Ocktacke; Chung, Cheol Hyun; Ro, Young Jin; Choi, In‐Cheol

doi:10.1111/j.1399-6576.2010.02275.x

Cited by 43 publications

(33 citation statements)

References 15 publications

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“…A subgroup analysis was conducted for 26 RCTs involving 4,878 patients in which the agents were administered during surgery [40, 43, 45, 53, 59, 74, 78, 79, 83, 86–89, 97, 102, 112, 113, 115, 117, 119, 123, 125, 132, 138, 142, 150]. The results were the same as for the primary analysis, except that significantly fewer patients of all ages receiving dolasetron experienced arrhythmia compared with placebo (OR 0.58, 95 % CI 0.36–0.93) and ramosetron (OR 0.38, 95 % CI 0.17–0.92) (Additional file 1: Appendix 13).…”

Section: Resultsmentioning

confidence: 99%

Comparative safety of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis

Tricco

Soobiah

Blondal

et al. 2015

BMC Med

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BackgroundSerotonin (5-HT3) receptor antagonists are commonly used to decrease nausea and vomiting for surgery patients, but these agents may be harmful. We conducted a systematic review on the comparative safety of 5-HT3 receptor antagonists.MethodsSearches were done in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify studies comparing 5-HT3 receptor antagonists with each other, placebo, and/or other antiemetic agents for patients undergoing surgical procedures. Screening search results, data abstraction, and risk of bias assessment were conducted by two reviewers independently. Random-effects pairwise meta-analysis and network meta-analysis (NMA) were conducted. PROSPERO registry number: CRD42013003564.ResultsOverall, 120 studies and 27,787 patients were included after screening of 7,608 citations and 1,014 full-text articles. Significantly more patients receiving granisetron plus dexamethasone experienced an arrhythmia relative to placebo (odds ratio (OR) 2.96, 95 % confidence interval (CI) 1.11–7.94), ondansetron (OR 3.23, 95 % CI 1.17–8.95), dolasetron (OR 4.37, 95 % CI 1.51–12.62), tropisetron (OR 3.27, 95 % CI 1.02–10.43), and ondansetron plus dexamethasone (OR 5.75, 95 % CI 1.71–19.34) in a NMA including 31 randomized clinical trials (RCTs) and 6,623 patients of all ages. No statistically significant differences in delirium frequency were observed across all treatment comparisons in a NMA including 18 RCTs and 3,652 patients.ConclusionGranisetron plus dexamethasone increases the risk of arrhythmia.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0379-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Comparative safety of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis

Tricco

Soobiah

Blondal

et al. 2015

BMC Med

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“…Ramosetron, another selective 5-HT 3 receptor antagonist, has been reported to be effective for the prevention and treatment of PONV after various surgeries [21-27]. Previous investigations have shown that ramosetron 0.3 mg was more effective than ondansetron 4 mg in patients with spine surgery, total knee arthroplasty, and laparoscopic cholecystectomy [22,24,27] and as effective as ondansetron 8 mg in patients with gynecological surgery and laparoscopic surgery [25,27].…”

Section: Discussionmentioning

confidence: 99%

A prospective, randomized, double-blind, and multicenter trial of prophylactic effects of ramosetron on postoperative nausea and vomiting (PONV) after craniotomy: comparison with ondansetron

et al. 2014

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BackgroundCraniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). This prospective, randomized, double-blind, multi-center study was performed to evaluate the efficacy of prophylactic ramosetron in preventing PONV compared with ondansetron after elective craniotomy in adult patients.MethodsA total of 160 American Society of Anesthesiologists physical status I–II patients aged 19–65 years who were scheduled to undergo elective craniotomy for various intracranial lesions were enrolled in this study. All patients received total intravenous anesthesia (TIVA) with propofol and remifentanil. Patients were randomly allocated into three groups to receive ondansetron (4 mg; group A, n = 55), ondansetron (8 mg; group B, n = 54), or ramosetron (0.3 mg; group C, n = 51) intravenously at the time of dural closure. The incidence of PONV, the need for rescue antiemetics, pain score, patient-controlled analgesia (PCA) consumption, and adverse events were recorded 48 h postoperatively.ResultsAmong the initial 160 patients, 127 completed the study and were included in the final analysis. The incidences of PONV were lower (nausea, 14% vs. 59% and 41%, respectively; P < 0.001; vomiting, P = 0.048) and the incidence of complete response was higher (83% vs. 37% and 59%, respectively; P < 0.001) in group C than in groups A and B at 48 h postoperatively. There were no significant differences in the incidence of PONV or need for rescue antiemetics 0–2 h postoperatively, but significant differences were observed in the incidence of PONV and complete response among the three groups 2–48 h postoperatively. No statistically significant intergroup differences were observed in postoperative pain, PCA consumption, or adverse events.ConclusionIntravenous administration of ramosetron at 0.3 mg reduced the incidence of PONV and rescue antiemetic requirement in craniotomy patients. Ramosetron at 0.3 mg was more effective than ondansetron at 4 or 8 mg for preventing PONV in adult craniotomy patients.Trial registrationClinical Research Information Service (CRiS) Identifier: KCT0000320. Registered 9 January 2012.

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“…Choi et al [8] reported that PCA-administered continuous infusion of ramosetron, combined with a single injection of ramosetron, significantly decreased the incidence of PONV. Ondansetron was also reported to be effective when administered continuously via a PCA [17].…”

Section: Discussionmentioning

confidence: 99%

“…In the case of another 5-HT 3 receptor antagonist, ramosetron, it was proposed that higher receptor occupancy indicated more extensive antiemetic action [19], and it was hypothesized that continuous infusion of the drug following single injection would maintain higher receptor occupancy [8]. Palonosetron exhibits significant receptor occupation for as long as 4 days [18].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the ability of continuous palonosetron infusion, using a patient-controlled analgesia device, to reduce postoperative nausea and vomiting

Kang

Park

2014

Korean J Anesthesiol

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BackgroundThe efficacy of palonosetron in preventing postoperative nausea and vomiting (PONV), as well as chemotherapy-induced nausea and vomiting, has already been demonstrated in multiple clinical studies. The purpose of this study was to determine whether continuous infusion of palonosetron following single injection could reduce PONV to a greater extent than single injection only of palonosetron.MethodsIn total, 132 women were enrolled in the study. All subjects were over the age of 20 years and were scheduled to undergo gynecologic laparoscopic surgery. Patients were randomly allocated into two groups. In both groups, patients received 0.075 mg of palonosetron intravenously, immediately before induction of anesthesia. In the continuous palonosetron infusion group, 0.075 mg (1.5 ml) of palonosetron was added to the patient-controlled analgesia device. In the single-injection palonosetron group, 1.5 ml of normal saline was added.ResultsThe incidence of PONV 24 hours postoperatively was significantly lower in the continuous palonosetron infusion group than the single-injection palonosetron group (31.8 vs. 56.1%, P = 0.009).ConclusionsContinuous palonosetron infusion, following single injection, reduces the incidence of PONV compared with single injection only.

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Prophylactic control of post‐operative nausea and vomiting using ondansetron and ramosetron after cardiac surgery

Abstract: The addition of either ondansetron or ramosetron to PCA can reduce the incidence of PONV during 48 h after cardiac surgery.

Cited by 43 publications

References 15 publications

Comparative safety of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis

Comparative safety of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis

A prospective, randomized, double-blind, and multicenter trial of prophylactic effects of ramosetron on postoperative nausea and vomiting (PONV) after craniotomy: comparison with ondansetron

Evaluation of the ability of continuous palonosetron infusion, using a patient-controlled analgesia device, to reduce postoperative nausea and vomiting

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