A randomized, double-blind study to evaluate the efficacy of ramosetron and palonosetron for prevention of postoperative nausea and vomiting after gynecological laparoscopic surgery

Abstract

BackgroundPostoperative nausea and vomiting (PONV) is a common complication after anesthesia and surgery; 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists have been considered as a first-line therapy. Ramosetron and palonosetron are more recently developed drugs and have greater receptor affinity and a longer elimination half-life compared with older 5-HT3 receptor antagonists. The purpose of this study was to determine which drug is more effective for preventing PONV between ramosetron and palonosetron.MethodsWe enrolled 100 patients undergoing gynecological laparoscopic surgery into this study. The subjects were divided into ramosetron group and palonosetron group. The medications were provided immediately before the induction of anesthesia. The occurrence of nausea and vomiting, severity of nausea according to a visual analogue scale, and rescue anti-emetic drug use were monitored immediately after the end of surgery and at 0-6 h, 6-24 h, and 24-48 h post-surgery.ResultsThe incidence of vomiting was significantly lower in the palonosetron group than in the ramosetron group during 0-6 h (6% vs 26%, P = 0.012) and 0-48 h (14% vs 34%, P = 0.034). The incidence of nausea and overall PONV, and the use of rescue antiemetic were not significantly different during all time intervals. The severity of nausea was not different between the two groups.ConclusionsIn conclusion, the incidence of PONV between the ramosetron and the palonosetron group have not shown the difference during 0-48 h, although palonosetron results in a lower incidence of vomiting during 0-6 h post-surgery.

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 Park SK, who found that the incidence of PONV between the Ramosetron group and the Palonosetron group did not demonstrate a difference during the 0-48 hour time period. [27] Our study results were comparable to Fuji Y et al, who found no difference between Granisetron and Ramosetron for prevention of PONV for a period of 0-24 hours after anaesthesia. [28] There was statistically significant difference regarding complete response during 4-24 hours postoperatively between Palonosetron and Granisetron.…”

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]. …”

“…Five studies [14,15,17,19,20] assessed the effectiveness of palonosetron and of ramosetron on early and four studies assessed the effectiveness of each drug on late PONV [15,17,19,20] and seven studies on overall PONV [14,15,17–21]. The combined results could not reveal the differences between the effectiveness of palonosetron and that of ramosetron on early PONV (RR 1.07; 95% CI, 0.60 to 1.92; P chi 2 = 0.03; I 2 = 63%; NNT 25.8; 95% CI, NNTH 8.7 to ∞ to NNTB 26.3), late PONV (RR 0.92; 95% CI 0.72 to 1.19; P chi 2 = 0.14; I 2 = 44.4%; NNTB 74.1; 95% CI, NNTH 14.4 to ∞ to NNTB 10.4) or overall PONV (RR 1.23; 95% CI 0.82 to 1.85; P chi 2 = 0.034; I 2 = 56.1%; NNTB 14.4; 95% CI, NNTH 7.2 to ∞ to NNTB 1957.8).…”

“…Five studies [15–17,19,20] compared palonosetron recipients to ramosetron recipients for the incidence of headaches. Analysis of the combined findings indicated no significant differences between the groups with respect to headaches (RR 1.06; 95% CI, 0.66 to 1.70; P chi 2 = 0.984; I 2 = 0.00%; NNTH 134.6; 95% CI, NNTH 17.2 to ∞ to NNTB 23.1).…”

Comparative study of effects of ramosetron and ondansetron on global satisfaction of patients on cisplatin chemotherapy in head and neck cancers

“…Similar results were shown by Park et al that is level of satisfaction was higher in ramosetron group as compared to Palonosetron, though it was not statistically significant (p>0.05). 20 Another study revealed no significant difference between level of satisfaction in between two groups (p>0.05). 21 In present study, we could not make out gender differences as far as response of the drugs are concerned.…”