The effect of oral and IV ramosetron on postoperative nausea and vomiting in patients undergoing gynecological laparoscopy with total intravenous anesthesia

Abstract

The effect of oral ramosetron 0.1 mg was comparable to that of IV ramosetron 0.3 mg on the prevention of PONV in women undergoing gynecological laparoscopy with TIVA. Both the oral and IV forms were effective at preventing PONV during the first 1 h after surgery.

Current Review of Ramosetron in the Prevention of Postoperative Nausea and Vomiting

“…The most commonly reported adverse effect was headache (5-20%). However, the incidence of headache was not different between patients receiving ramosetron and those receiving placebo [14][15][16][17][20][21][22][23][24][25][26][27][28][29]. For pediatric patients, clinically serious AEs, including excessive sedation and extrapyramidal symptoms, attributable to ramosetron were not observed in children [27][28][29][30] .…”

“…Similarly, ramosetron 0.3 mg administered IV at the end of surgery was more effective than placebo for the prophylaxis against PONV during 0-24 h after anesthesia in 80 women undergoing dilatation and curettage [15], 100 patients (35 men and 65 women) undergoing laparoscopic cholecystectomy [16], 100 patients (35 men and 65 women) undergoing middle ear surgery [17], 80 patients (22 men and 58 women) undergoing thyroidectomy [18], and 80 patients (22 men and 58 women) undergoing total hip replacement [19]. Ramosetron 0.1 mg given orally was as effective as ramosetron 0.3 mg administered IV for preventing PONV during 0-24 h after anesthesia in 120 women undergoing gynecologic laparoscopy The incidence was 12% with PO ramosetron and 10% with IV ramosetron [20]. By contrast, Lee et al demonstrated that ramosetron 4 mcg kg -1 administered IV immediately before induction of anesthesia was ineffective for preventing PONV during 0-24 h after anesthesia in 113 patients (19 men and 94 women) undergoing thyroidectomy.…”

“…For adult patients, postoperatively, adverse events (AEs), including headache, dizziness, and drowsiness, were found in 12 published articles [14][15][16][17][20][21][22][23][24][25][26][27][28][29]. The most commonly reported adverse effect was headache (5-20%).…”

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

“…Ramosetron is an effective treatment for vomiting in cancer patients receiving chemotherapy [16][17][18] and many studies have concluded that prophylactic therapy with ramosetron is effective for preventing PONV after various surgical procedures [7,19,20]. The precise antiemetic mechanism of ramosetron remains unclear, but it may act on sites containing receptors that have demonstrated antiemetic effects [18].…”

“…Because of its higher binding affinity to the receptor and slower dissociation rate, ramosetron is more potent and has longer-lasting antiemetic effects than older agents [3,4]. Ogata et al [5] [6,7].…”