Ramosetron for the prevention of postoperative nausea and vomiting (PONV): a meta-analysis

Kim, Won Oak; Koo, Bon Nyeo; Kim, Yong Kook; Kil, Hae Keum

doi:10.4097/kjae.2011.61.5.405

Cited by 21 publications

(18 citation statements)

References 41 publications

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“…In the study by Lee [27], the effective dose of ramosetron for prophylaxis of PONV in high-risk patients was 0.6 mg, which was higher than the dose in our studies (0.3 mg). However, in the meta-analysis, 0.6 mg of ramosetron showed no greater benefits than 0.3 mg [25]. Also, significantly fewer instances of PONV occurred in the group that received 0.3 mg of ramosetron than in the placebo group [25].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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Previous randomized controlled trials have reported conflicting findings on the superiority of palonosetron over ramosetron for preventing postoperative nausea and vomiting (PONV). Therefore, the present systematic review was registered in PROSPERO (CRD42016038120) and performed to compare the efficacy of perioperative administration of palonosetron to that of ramosetron for preventing PONV. We searched MEDLINE, EMBASE, and CENTRAL to identify all randomized controlled trials that compared the effectiveness of perioperative administration of palonosetron to that of ramosetron. The primary endpoints were defined as the incidence of postoperative nausea (PON), postoperative vomiting (POV), and PONV. A total of 695 patients were included in the final analysis. Subgroup analysis was performed through administration times which were divided into two phases: the early phase of surgery and the end of surgery. Combined analysis did not show differences between palonosetron and ramosetron in the overall incidence of PON, POV or PONV. Palonosetron was more effective than ramosetron, when the administration time for the 5-HT3 receptor antagonist was during the early phase of the operation. Otherwise, ramosetron was more effective than palonosetron, when the administration time was at the end of surgery. However, the quality of evidence for each outcome was low or very low and number of included studies was small, limiting our confidence in findings.

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Section: Discussionmentioning

confidence: 99%

“…However, in the meta-analysis, 0.6 mg of ramosetron showed no greater benefits than 0.3 mg [25]. Also, significantly fewer instances of PONV occurred in the group that received 0.3 mg of ramosetron than in the placebo group [25]. …”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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“…[10] Many of the recent studies have shown that ramosetron is more effective than ondansetron in preventing PONV for the patients undergoing various other surgeries. [8111213] Furthermore, antiemetic efficacy of combination of ramosetron and dexamethasone was found to be similar to that of ondansetron and dexamethasone, when used as prophylaxis for the spine surgeries. [14] Addition of dexamethasone did not provide any advantage to ramosetron.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the antiemetic effect of ramosetron with the combination of dexamethasone and ondansetron in middle ear surgery: A double-blind, randomized clinical study

et al. 2013

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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).Conclusion:The combination of dexamethasone and ondansetron is superior to ramosetron for prevention of PONV after middle ear surgeries.

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“…Clinically, ramosetron is more effective for reducing PONV than granisetron [15] or ondansetron [16,17]. In a meta-analysis, ramosetron 0.3 mg was consistently beneficial for preventing PONV (relative risk 0.4, 95% confidence interval (CI) 0.3-0.6), when compared to placebo, and it was also safe, producing no serious adverse events [18]. However, despite prophylaxis with ramosetron, PONV has still been reported in more than 30% of patients [15,17].…”

Section: Discussionmentioning

confidence: 99%

Dose-Ranging Study of Ramosetron for the Prevention of Nausea and Vomiting after Laparoscopic Gynecological Surgery: A Prospective Randomized Study

Cho

Kim

Lee

et al. 2019

JCM

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Patients undergoing laparoscopic gynecologic surgery and receiving postoperative analgesia with opioids have a high risk of postoperative nausea and vomiting (PONV). We compared the antiemetic efficacy of three doses of ramosetron in this high-risk population. In this prospective, double-blind trial, 174 patients randomly received ramosetron 0.3 mg (R0.3 group; n = 58), 0.45 mg (R0.45 group; n = 58), or 0.6 mg (R0.6 group; n = 58) at the end of surgery. The primary outcome was the incidence of PONV during the first postoperative 48 h. Nausea severity, pain scores, adverse events, and patient satisfaction (1–4; 4, excellent) were assessed. The incidence of PONV was not different between groups (35%, 38%, and 35% in R0.3, R0.45, and R0.6 groups; p = 0.905). Nausea severity, pain scores, and incidence of adverse events (dizziness, headache, or sedation) were similar between groups. Compared to the R0.3 group, the R0.45 and R0.6 groups had lower incidence of premature discontinuation of fentanyl-based patient-controlled analgesia primarily because of intractable PONV (9% and 5% vs. 24%; p = 0.038), and higher satisfaction scores (3.4 ± 0.8 and 3.3 ± 0.7 vs. 2.4 ± 0.9; p = 0.005). Compared to ramosetron 0.3 mg, ramosetron 0.45 and 0.6 mg did not reduce PONV, but reduced premature discontinuation of patient-controlled analgesia and increased patient satisfaction, without increasing adverse events.

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Ramosetron for the prevention of postoperative nausea and vomiting (PONV): a meta-analysis

Cited by 21 publications

References 41 publications

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

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

Comparison of the antiemetic effect of ramosetron with the combination of dexamethasone and ondansetron in middle ear surgery: A double-blind, randomized clinical study

Dose-Ranging Study of Ramosetron for the Prevention of Nausea and Vomiting after Laparoscopic Gynecological Surgery: A Prospective Randomized Study

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