Comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting: An updated systematic review and meta-analysis with trial sequential analysis

Yokoi, Ayako; Mihara, Takahiro; Ka, Koui; Goto, Takahisa

doi:10.1371/journal.pone.0186006

Cited by 27 publications

(19 citation statements)

References 44 publications

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“…Fatigue is associated with NVP in several studies [15][16] . Also, agreed with Yokoi et al [17] who noticed that the main side effects ondansetron were dizziness, headache and drowsiness. In addition, when considering the maternal safety that associated with first trimester, manifestations such as tendency to sleep, fatigue & dehydration, may be inaccurately linked to the medication, rather than to pregnancy and/or NVP.…”

Section: Disucssionsupporting

confidence: 90%

Ondansetron compared with doxylamine and pyridoxine for treatment of nausea and vomiting in pregnancy

Yahia

Khattab

Hamed

2020

International Journal of Medical Arts

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Background: Nausea and vomiting affects up to 80% of the pregnant women population and are the third leading causes of maternal hospitalization during pregnancy. Many pregnant females, and even some healthcare professionals, dread using antiemetic drugs due to a false belief of their teratogenic risk. Aim of the work: This study aimed to evaluate ondansetron to a combination of doxylamine and pyridoxine in controlling pregnancy-related nausea and vomiting. Patients and Methods: This randomized controlled trial included 156 pregnant women, at 16 weeks of gestation, with mild-tomoderate nausea and vomiting. Meanwhile, women with severe symptoms indicating admission, those already on anti-emetics, and those who wouldn't be able to show up for follow-up visits were excluded. Seventy-eight patients received intravenous injection of ondansetron [Zofran] at a dose of 8 mg once daily for 5 days, whereas the other 78 patients received oral pyridoxine at a dose of 25 mg plus doxylamine at a dose of 12.5 mg [Diclegis] twice daily for 5 days. Each patient was subjected to full history taking, complete clinical examination and investigations. Results: Women on Ondansetron reported better alleviation of nausea compared to those receiving pyridoxine and doxylamine [96.2% vs. 52.6%, P<0.001, respectively]. The most frequently reported side effects were headache, dry mouth, gastrointestinal [GI] disturbances, and abdominal pain, and the differences in their occurrence between the two groups were statistically insignificant. Conclusion: Ondansetron was found superior to the combination of pyridoxine and doxylamine in improving pregnancy-related nausea and vomiting occurring without a significant increase in side effects.

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Section: Disucssionsupporting

confidence: 90%

Ondansetron compared with doxylamine and pyridoxine for treatment of nausea and vomiting in pregnancy

Yahia

Khattab

Hamed

2020

International Journal of Medical Arts

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“…Therefore, it is reasonable to use ramosetron, which can reduce PONV by 48 h postoperatively. 5-HT3 antagonists (ramosetron and ondansetron) are reported to have side effects including headache, dizziness, and drowsiness [37]. In our study, the incidence of headache was significantly higher in patients receiving 5-HT3 antagonists than in patients of control group by 0-6 h postoperatively, but the incidences of headache by 6-48 h and dizziness and drowsiness did not differ for the three groups.…”

Section: Discussioncontrasting

confidence: 50%

The effectiveness of ramosetron and ondansetron for preventing postoperative nausea and vomiting after arthroscopic rotator cuff repair: a randomized controlled trial

Lee

Kim

2020

J Orthop Surg Res

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Background Arthroscopic rotator cuff repair is a painful procedure, and treatment of emetic events associated with drugs used in the current multimodal pain management remains challenging. This study aimed to evaluate the effectiveness of ramosetron or ondansetron to relieve postoperative nausea and vomiting (PONV) and pain after arthroscopic rotator cuff repair. Methods In total, 122 consecutive patients undergoing arthroscopic rotator cuff repair were randomly allocated into three groups: ramosetron group (n = 39), ondansetron group (n = 43), and control group (n = 40). Then, 0.3 mg of ramosetron or 8 mg of ondansetron was administered intravenously at the end of surgery according to group. All patients received general anesthesia and multimodal pain management protocol including preemptive analgesic medication, fentanyl-based intravenous patient-controlled analgesia, and postoperative analgesic medication. Incidence of emetic events, rescue antiemetic requirements (10 mg of metoclopramide, IV), complete response, pain level, and side effects were recorded in three periods: 0–6, 6–24, and 24–48 h postoperatively. The severity of nausea and pain was evaluated using a visual analog scale. Results The ramosetron group tended to have a lower incidence and severity of nausea during the 6- to 24-h postoperative period and fewer rescue antiemetic drug requirements during the 0- to 48-h period than the control group, showing statistical significance. Additionally, the frequency of complete response of the ramosetron and ondansetron groups was significantly higher than that of the control group. No difference was found among the groups in the pain level except during the 0- to 6-h period. The two groups have a higher complete response during the 6- to 24-h period than the control group. Conclusions Ramosetron use led to a lower incidence, mild severity of nausea, and reduced use of rescue antiemetic drug after arthroscopic rotator cuff repair during the 6- to 24-h postoperative period than the control. Level of evidence Level I, randomized controlled trials, treatment study

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“…The Neurokinin-1 receptor antagonists, corticosteroids, butyrophenone and antihistamines are also recommended. However, antiemetic agents raise different concerns just like the risk of QT prolongation in 5-HT 3 receptor antagonists and the effect on postoperative infection as well as blood glucose levels in corticosteroids [ 21 , 22 ]. Here in this study, penehyclidine, an anticholinergic agent, significantly reduced the incidence of PONV in patients undergoing strabismus surgery.…”

Section: Discussionmentioning

confidence: 99%

Penehyclidine mitigates postoperative nausea and vomiting and intraoperative oculocardiac reflex in patients undergoing strabismus surgery: a prospective, randomized, double-blind comparison

Sun

Cao

et al. 2021

BMC Anesthesiol

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Background Postoperative nausea and vomiting (PONV) is one of the most frequent complications following strabismus surgery. Penehyclidine, an anticholinergic agent, is widely used as premedication. This study investigated the effect of preoperative penehyclidine on PONV in patients undergoing strabismus surgery. Methods In this prospective, randomized, double-blind study, patients scheduled for strabismus surgery under general anesthesia were randomly assigned to either penehyclidine (n = 114) or normal saline (n = 104) group. Penehyclidine was administrated immediately after anesthesia induction, and normal saline was substituted as control. PONV was investigated from 0 to 48 h after surgery. Intraoperative oculocardiac reflex (OCR) was also recorded. Results Compared with normal saline, penehyclidine significantly reduced PONV incidence (30.7% vs. 54.8%, P < 0.01) and mitigated PONV severity as indicated by severity scoring (P < 0.01). Compared with normal saline, penehyclidine also significantly reduced OCR incidence (57.9% vs. 77.9%, P < 0.01) and mitigated OCR severity, as indicated by the requirement for atropine rescue (77.3% vs. 90.1%, P < 0.05) and the maximum decrease of heart rate during OCR (23.1 ± 9.4 bpm vs. 27.3 ± 12.4 bpm, P < 0.05). The recovery course did not differ between groups. Conclusions Penehyclidine administrated after anesthesia induction significantly reduced the incidence of PONV and alleviated intraoperative OCR in patients undergoing strabismus surgery. Trial registration ClinicalTrials.gov (NCT04054479). Retrospectively registered August 13, 2019.

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Comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting: An updated systematic review and meta-analysis with trial sequential analysis

Cited by 27 publications

References 44 publications

Ondansetron compared with doxylamine and pyridoxine for treatment of nausea and vomiting in pregnancy

Ondansetron compared with doxylamine and pyridoxine for treatment of nausea and vomiting in pregnancy

The effectiveness of ramosetron and ondansetron for preventing postoperative nausea and vomiting after arthroscopic rotator cuff repair: a randomized controlled trial

Penehyclidine mitigates postoperative nausea and vomiting and intraoperative oculocardiac reflex in patients undergoing strabismus surgery: a prospective, randomized, double-blind comparison

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