Effect of Oral Ramosetron for Postoperative Nausea and Vomiting in Surgical Patients using PatientControlled Analgesia / 대한마취과학회지

ABSTRACT

BACKGROUND: This study was designed to evaluate ramosetron oral disintegrating tablet (ODT), a 5-HT3 receptor antagonist, for prophylaxis and treatment of postoperative nausea and vomiting (PONV) in patients undergoing general anesthesia using patient controlled analgesia (PCA). METHODS: 150 adult, ASA physical status I or II, aged 18-65 yr, patients undergoing elective surgery were enrolled (n = 50 in each). Patients were randomly assigned to one of three groups, group C (no prophylactic antiemetics), groups N (ramosetron ODT 30 minutes before the induction), and group Z (intravenous injection of ondansetron 4 mg at the end of surgery followed by continuous infusion of 8 mg added to the PCA solution). A standard general inhalation anesthesia and IV PCA with fentanyl and ketorolac were used. During the 48 hours after recovery, we assessed pain score by using a visual analogue scale (VAS), a sedation scale, an incidence of PONV, and monitoring consumption of PCA drug, rescue drug consumption, adverse events, and overall satisfaction. RESULTS: The incidence of nausea and the consumption of rescue drug were significantly decreased in N and Z groups at each time point except 24-48 hours after recovery. There was no significant difference in incidence of vomiting. Overall satisfaction was superior in N and Z groups compared with C group. CONCLUSIONS: Preoperative administration of ramosetron ODT was an acceptable and effective way to prevent PONV in patients using PCA.