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Prophylactic control of post-operative nausea and vomiting using ondansetron and ramosetron after cardiac surgery.

Author(s): Choi DK, Chin JH, Lee EH, Lim OB, Chung CH, Ro YJ, Choi IC

Affiliation(s): Department of Anesthesiology and Pain Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

Publication date & source: 2010-09, Acta Anaesthesiol Scand., 54(8):962-9. Epub 2010 Jul 12.

Publication type: Comparative Study; Randomized Controlled Trial

BACKGROUND: The aim of this study was to evaluate the efficacy of ondansetron and ramosetron in the reduction of post-operative nausea and vomiting (PONV) associated with patient-controlled analgesia (PCA) after cardiac surgery. METHODS: A total of 320 patients scheduled for elective cardiac surgery were enrolled. Patients were randomly assigned to one of four treatment regimens (n=80 in each group): no prophylactic antiemetics (group P); intravenous (i.v.) ondansetron 4 mg at the end of surgery and 12 mg added to PCA (group O); i.v. ramosetron 0.3 mg at the end of surgery and no antiemetics added to PCA (group R1); and i.v. ramosetron 0.3 mg at the end of surgery and 0.6 mg added to PCA (group R2). RESULTS: The incidence of PONV during the 48-h post-operative period was lower in groups O (46%), R1 (54%), and R2 (35%) compared with group P (71%, P<0.001). The incidence and severity of nausea were lower in groups O, R1, and R2 than in group P during the 24-h post-operative period, whereas the incidence and severity of nausea during 24-48 h after surgery were lower in groups O and R2, but not in group R1, than in group P. Compared with group P (53%), the frequency of rescue antiemetic usage was significantly lower in groups O (34%) and R2 (29%), but not in group R1 (43%). CONCLUSION: The addition of either ondansetron or ramosetron to PCA can reduce the incidence of PONV during 48 h after cardiac surgery.

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