Effect of Oral Ramosetron for Postoperative Nausea and Vomiting in Surgical Patients using Patient Controlled Analgesia

Lee, Hyeon-Jeong; Shin, Chang-Seok; Choi, Bong-Soo; Yoon, Jeong Whan; Kwon, Jae‐Young; Kim, Hae-Kyu

doi:10.4097/kjae.2008.54.1.63

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…We included 27 RCTs [ 6 , 18 – 43 ] with 3,811 patients ( Fig 1 ). Of the 27 studies, 23 were available in English and four [ 32 , 34 , 36 , 37 ] in Korean. The PRISMA checklist is provided in the supporting information ( S1 Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Surgical procedures varied among the RCTs and included minor surgery, laparoscopic surgery, orthopedic surgery, major abdominal surgery, pulmonary lobectomy, craniotomy, and cardiac surgery. The ondansetron dose was 4 mg in 13 RCTs [ 18 , 21 , 24 , 25 , 27 , 28 , 30 – 32 , 37 , 39 , 41 , 42 ], 8 mg in five RCTs [ 19 , 22 , 33 , 36 , 40 ], both 4 mg and 8 mg in three RCTs [ 6 , 20 , 23 ], and other doses in six RCTs [ 26 , 29 , 34 , 35 , 38 , 43 ]. All RCTs used 0.3 mg of ramosetron except for four studies [ 26 , 29 , 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

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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

Yokoi

Mihara

et al. 2017

PLoS ONE

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BackgroundPostoperative nausea and vomiting is a distressing complication of surgery, and 5-HT3 receptor antagonists are often prescribed to prevent it. Ondansetron is the agent typically administered to prevent postoperative nausea and vomiting. Although ramosetron has a longer duration of action than ondansetron, it remains unclear whether ramosetron is the more effective medication. We performed an updated meta-analysis on the comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting.MethodsWe searched six databases for all trials that randomly assigned patients to ramosetron or ondansetron groups. The primary outcome was postoperative nausea or vomiting in the early, late, and next-day periods. The secondary outcomes were side effects of the medications. We used the random-effects model to combine the results. Trial sequential analyses were performed to correct for repetitive testing in the updated meta-analysis.ResultsTwenty-seven randomized controlled trials with 3,811 patients were included in the meta-analysis. The combined results of ramosetron vs. ondansetron efficacy in preventing postoperative nausea and vomiting were as follows: Risk ratio [95% confidence interval] = 0.82 [0.69–0.98] for early postoperative nausea, 0.76 [0.65–0.89] for late postoperative nausea, 0.69 [0.57–0.84] for next-day postoperative nausea, 0.78 [0.63–0.98] for early postoperative vomiting, 0.57 [0.45–0.72] for late postoperative vomiting, and 0.61 [0.43–0.86] for next-day postoperative vomiting. Dizziness was significantly lower in ramosetron groups than in ondansetron groups (risk ratio [95% confidence interval] = 0.81 [0.66–0.98]). Trial sequential analysis revealed that the results for late postoperative nausea, late postoperative vomiting, and next-day postoperative nausea were conclusive.ConclusionsRamosetron is more effective in preventing late postoperative nausea, late postoperative vomiting, and next-day postoperative nausea than ondansetron. The incidence of dizziness may be lower in patients receiving ramosetron than in patients receiving ondansetron.Trial registrationUniversity hospital Medical Information Network Clinical Trials Registry: UMIN000022980

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

Yokoi

Mihara

et al. 2017

PLoS ONE

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“…In a prospective randomized double-blind study by Choi et al, 15) ramosetron was shown to have a greater analgesic effect and to be associated with a third less PONV than ondansetron; both drugs are Hydroxytryptamine receptor 3 antagonists, but ramosetron has a higher binding affinity to the receptor than Ondansetron. Lee et al 8) reported that an oral administration of ramosetron give 30 minutes before the operation reduces PONV more than when it is given after general anesthesia. The use of postoperative analgesics has been associated with adverse events.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5][6][7] Other studies have found that the prophylactic use of antiemetics with the opioids reduces postoperative nausea and vomiting (PONV). 8) These two findings were taken into consideration when formulating our PCA medication. One of the analgesics used in this study was oxycodone, a strong opioid that acts on mu-and kappa-opioid receptors.…”

Section: Discussionmentioning

confidence: 99%

An Analysis on the Effect of Patient-controlled Analgesia Performed by Orthopaedic Department or Postoperative Pain Control after Shoulder and Elbow Surgery

Yum¹,

Kim²,

Boo³

et al. 2015

Clinics in Shoulder and Elbow

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Background: We investigated the effectiveness of pain management and the adverse events of intravenous (IV) patient-controlled analgesia (PCA) after orthopedic surgery. Methods: From September 2014 and August 2015, we performed a retrospective analysis of 77 patients who underwent orthopedic surgery of the shoulder or the elbow in our hospital. The composition of the intravenous PCA administered to the patients was as follows: 250 mg of dexketoprofen trametamol, 70 mg of oxycodone, and 0.6 mg of ramosetron, which were made up to 79 ml of normal saline. We evaluated and statistically analyzed the difference in the visual analogue scale (VAS) scores for pain at immediate postoperation, at 24 hours of PCA, at 72 hours of PCA, and after discontinuation of PCA and in the incidence of adverse events. Results: We found that VAS score decreased for 3 postoperative days and that with discontinuation of IV PCA a meaningful change in VAS score was no longer seen. Of the 77 patients, 22 presented with adverse events (28.6%). We terminated IV PCA temporarily in the 21 patients who presented with adverse events; we terminated analgesia permanently in one patient (1.2%). Consequently, 76 of 77 patients carried out IV PCA till the designated period. Conclusions: Intravenous PCA after orthopedic surgery of the shoulder or the elbow may be accompanied with adverse events. Careful assessment of the patient and treatment of the adverse outcomes are key to a successful maintenance of PCA and to a successful management of postoperative pain. (Clin Shoulder Elbow 2015;18(4):237-241)

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Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis

Weibel

Rücker

Eberhart

et al. 2020

Cochrane Database of Systematic Reviews

118

133

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Effect of Oral Ramosetron for Postoperative Nausea and Vomiting in Surgical Patients using Patient Controlled Analgesia

Cited by 5 publications

References 21 publications

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

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

An Analysis on the Effect of Patient-controlled Analgesia Performed by Orthopaedic Department or Postoperative Pain Control after Shoulder and Elbow Surgery

Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis

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