Comparison of ramosetron and ondansetron for the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: a meta-analysis of randomized controlled trials

Abstract

Objective We conducted a systematic literature search and meta-analysis to identify randomized controlled trials (RCTs) comparing the efficacy and safety of ramosetron versus ondansetron for the prevention of postoperative nausea and vomiting (PONV; PON and POV, respectively) in patients undergoing laparoscopic surgery. Methods The electronic databases PubMed, EMBASE, Web of Science, and Cochrane Library were searched up to March 2019 to identify relevant studies. Results The final pooled analysis included 6 RCTs and revealed that postoperative treatment with ramosetron at 24 to 48 hours after surgery significantly reduced the incidence of PON and POV relative to treatment with ondansetron. In a subgroup analysis, ramosetron 0.3 mg tended to reduce PON (0–2 hours) and POV (24–48 hours) more effectively than ondansetron 4 mg. However, no statistical difference was observed between ramosetron 0.3 mg and ondansetron 8 mg in terms of the reduction of PON or POV during any time interval within the first 48 hours after surgery. Conclusions Our results indicate that ramosetron 0.3 mg is superior to ondansetron 4 mg and comparable to ondansetron 8 mg for PONV prophylaxis after laparoscopic surgery.

A study to compare ramosetron and ondansetron for prevention of post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anesthesia

“…Our findings are consistent with meta-analysis done by Li et al, in which they found no difference in prevention of PONV in 0.3 mg ramosetron and 8 mg ondansetron in first 48 h after surgery but 0.3 mg ramosetron was found to be more effective than four mg ondansetron in reduction of post-operative nausea in 0-2-h period and post-operative vomiting in 24-48-h period. 16 Similarly Opneja et al, did not found any statistical significant difference in the incidence of PONV in 0.3 mg ramosetron and 8 mg ondansetron group in first 24 h after surgery. 17 These findings are in agreement with the findings of Ansari et al, in which ramosetron was compared with ondansetron for prevention of PONV in patients who underwent laparoscopic cholecystectomy.…”

A randomized controlled trial of the effect of ramosetron on postoperative restoration of bowel motility after gynecologic laparoscopic surgery

“…Exclusion criteria were: (1) use of steroids or antiemetics within 24 h before the surgery; (2) patients with liver, pulmonary, cardiac, gastrointestinal, or renal diseases; pregnancy; body mass index above 35; insulin-dependent diabetes mellitus; and allergy to any of the medications used in the study; (3) patients with a history of drug abuse, PONV, or smoking; and (4) a change from laparoscopic to an open approach during surgery. Female patients were allocated to the ramosetron group (group R) or the control group (group C) using a computerized randomization table.…”

“…They are effective in preventing and treating PONV and have fewer adverse effects than other types of antiemetics 2 . Ramosetron, a 5‐HT 3 receptor antagonist, is more effective than other 5‐HT 3 receptor antagonists, has a higher affinity for the receptor, and exhibits a longer duration of action compared with previously developed antagonists 3,4 . However, ramosetron has been reported to inhibit the stimulation of defecation caused by mental stress and corticotrophin‐releasing hormone and is effective in the treatment of irritable bowel symptoms 5 .…”

“…2 Ramosetron, a 5-HT 3 receptor antagonist, is more effective than other 5-HT 3 receptor antagonists, has a higher affinity for the receptor, and exhibits a longer duration of action compared with previously developed antagonists. 3,4 However,…”