Ramosetron versus ondansetron for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy

Ryu, Jung Hee; So, Yun Mi; Hwang, Jung‐Won; Hwan, Sang

doi:10.1007/s00464-009-0670-5

Cited by 63 publications

(81 citation statements)

References 43 publications

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“…The precise antiemetic mechanism of ramosetron remains unclear, but it may act on sites containing receptors that have demonstrated antiemetic effects [18]. Many studies have examined the prophylactic antiemetic effects of ramosetron compared with other 5-HT3 receptor antagonists including ondansetron and granisetron [21,22]. Choi et al [6] concluded that ramosetron 0.…”

Section: Resultsmentioning

confidence: 99%

Comparison of prophylactic anti-emetic effects of ramosetron between single bolus administration and continuous infusion following bolus administration

Doo

Kim

et al. 2016

Anesth Pain Med

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:The authors hypothesized that the continuous infusion of ramosetron 0.15 mg following a 0.15 mg bolus administration would maintain higher 5-hydroxytryptamine type 3 receptor occupancy levels and be more effective in preventing postoperative nausea and vomiting (PONV) than a 0.3 mg single bolus administration. We conducted a study to compare the efficacy of single bolus ramosetron administration with the combination of continuous infusion following intravenous bolus administration for PONV prophylaxis. Methods: One hundred and fifty female patients undergoing thyroidectomy were allocated randomly to one of three groups to receive a placebo (Group 1, n = 49), 0.3 mg of IV ramosetron (Group 2, n = 53), or the continuous infusion of 0.15 mg ramosetron following a bolus administration of 0.15 mg of ramosetron (Group 3, n = 48). Anesthesia was maintained with sevoflurane and N2O. The incidence of PONV, nausea severity, and use of rescue antiemetics during the postoperative 24 hours were recorded. Results: Group 1 showed higher incidences of PONV during the postoperative 24 hour than Group 2 (81% vs. 58%, P = 0.02) and Group 3 (81% vs. 48%, P ＜ 0.01), but there was no difference between Groups 2 and 3 (P = 0.39). The use of rescue antiemetics was significantly lower in Groups 2 and 3 than Group 1 during the postoperative 6 to 24 hours. Conclusions: There were no significant differences of incidence and severity of PONV between ramosetron 0.3 mg single bolus administration and the combination of ramosetron infusion after 0.15 mg bolus administration. (Anesth Pain Med 2016; 11: 166-171)

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Section: Resultsmentioning

confidence: 99%

Comparison of prophylactic anti-emetic effects of ramosetron between single bolus administration and continuous infusion following bolus administration

Doo

Kim

et al. 2016

Anesth Pain Med

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“…

With great interest, we read the article by Ryu et al [1] comparing the prophylactic efficacy of ondansetron and ramosetron for relieving PONV after laparoscopic cholecystectomy. The study added to the growing body of evidence that ramosetron is as effective as ondansetron for PONV prophylaxis.

First, we comment on the methodology of the study.

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confidence: 99%

Matching groups for studying postoperative nausea and vomiting: should we care?

Mraović

Šimurina

2010

Surg Endosc

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With great interest, we read the article by Ryu et al. [1] comparing the prophylactic efficacy of ondansetron and ramosetron for relieving PONV after laparoscopic cholecystectomy. The study added to the growing body of evidence that ramosetron is as effective as ondansetron for PONV prophylaxis.First, we comment on the methodology of the study. In small studies, the potential for bias is high if care is not taken to control for the all factors that influence the results and the hypothesis. The etiology of PONV is multifactorial and not completely explained. Multiple potential risk factors exist [2-4], but control should be used for well-known risk factors in all PONV studies. This control for risk factors should be done either by excluding the patients with the risk factors or by studying groups comparable in terms of the risk factors [5].In this study, the simplified risk score was not reported. Moreover, nonsmoking status, as the well known risk factor, was not reported. We think that all PONV studies should report the simplified risk score [4] for all groups and exclude the patients with the potential risk factor as we did in our study examining the influence of nitrous oxide on PONV [6]. This would ensure that all the studied groups have the same baseline risk for PONV.Second, the results of the study were presented as the ratio of the complete response (no PONV) rather than the percentage of PONV incidence. However, the authors failed to present the cumulative result for the entire 48 h period of the study, as recommended [5].Third, the severity of nausea was recorded by a verbal rating scale (VRS) but not reported. At the same time, the VRS for pain was reported. Furthermore, the VRS for pain was used for rescue pain medication. Was the VRS for nausea used for the rescue PONV medication?Finally, the authors stated that the role of nitrous oxide in increasing PONV is still debated. We disagree because ENIGMA [7], a large multicenter trial, showed that nitrous oxide increases the risk for PONV. Moreover, our pilot study [6] showed that nitrous oxide increases the incidence of PONV in a dose-response fashion.Disclosures Boris Mraovic and Tatjana Š imurina have no conflicts of interest or financial ties to disclose. References 1. Ryu J, So Y-M, Hwang J, Do S-H (2009) Ramosetron versus ondansetron for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Surg Endosc.

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“…8 Among the 5-HT 3 antagonists, ramosetron (Nasea Õ ; Astellas Pharma Korea Inc., Seoul, Republic of Korea) is a newly developed drug with higher 5-HT 3 receptor affinity and longer duration of action than its congeners such as ondansetron and granisetron. 9 Midazolam, which is a rapid and short-acting benzodiazepine, has been widely used as a premedicant: several investigators have demonstrated the antiemetic properties of midazolam, when administered as a bolus before or after induction of anaesthesia, or given postoperatively as a continuous infusion. [10][11][12] Although several studies have reported the combination therapy of 5-HT 3 antagonists and antiemetics with different mechanisms of action, 13,14 the prophylactic effect of a combination of ramosetron and midazolam for PONV has not been assessed in patients after thyroidectomy.…”

Section: Introductionmentioning

confidence: 99%

Ramosetron, midazolam, and combination of ramosetron and midazolam for prevention of postoperative nausea and vomiting: A prospective, randomized, double-blind study

et al. 2013

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Objective: To compare the efficacy of ramosetron, midazolam, and the combination of ramosetron and midazolam in the prevention of postoperative nausea and vomiting (PONV) in female patients undergoing thyroidectomy. Methods: Patients were randomized to receive 0.3 mg ramosetron (Group R), 75 mg/kg midazolam (Group M) or 0.3 mg ramosetron combined with 75 mg/kg midazolam (Group RM) before the induction of anaesthesia. PONV, use of rescue antiemetics, pain severity and fentanyl consumption were assessed for 24 h after thyroidectomy. Results: A total of 100 patients were enrolled; 94 patients completed the study. The severity of nausea was statistically significantly reduced at 0-2 h in Group RM compared with Groups R and M, and at 2-6 h in Group RM compared with Group M. The incidence of retching and vomiting was significantly lower at 0-2 h, 2-6 h, 6-12 h in Group RM than in Group M, and lower in Group R than Group M at 6-12 h. The requirement for rescue antiemetics was significantly lower at 0-2 h in group RM than in group M. Conclusion: The combination therapy of ramosetron and midazolam provided superior antiemetic efficacy compared with midazolam single therapy, but did not show any significant additional benefits compared with ramosetron single therapy.

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Ramosetron versus ondansetron for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy

Abstract: Ramosetron 0.3 mg and ondansetron 8 mg are more effective than ondansetron 4 mg for the prevention of PONV (2 h). Ramosetron 0.3 mg is as effective as ondansetron 8 mg for the prophylaxis of PONV after laparoscopic cholecystectomy.

Cited by 63 publications

References 43 publications

Comparison of prophylactic anti-emetic effects of ramosetron between single bolus administration and continuous infusion following bolus administration

Comparison of prophylactic anti-emetic effects of ramosetron between single bolus administration and continuous infusion following bolus administration

Matching groups for studying postoperative nausea and vomiting: should we care?

Ramosetron, midazolam, and combination of ramosetron and midazolam for prevention of postoperative nausea and vomiting: A prospective, randomized, double-blind study

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