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Efficacy of palonosetron and ramosetron on postoperative nausea and vomiting related to intravenous patient-controlled analgesia with opioids after gynecological laparoscopic surgery (double-blinded prospective randomized controlled trial)

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Abstract

Purpose

The study was designed to assess the efficacy of palonosetron and ramosetron in preventing postoperative nausea and vomiting (PONV) related to intravenous (IV) patient-controlled analgesia (PCA) with opioids after gynecological laparoscopic surgery.

Methods

Patients were randomly allocated to 4 groups—C, P, R0.3 and RPCA. At the end of surgery, group C received an infusion of 50 ml normal saline, group P received palonosetron 75 μg mixed in 50 ml normal saline, and groups R0.3 and RPCA received ramosetron 0.3 mg mixed in 50 ml normal saline. A PCA pump containing fentanyl was connected for all groups; however, ramosetron 0.6 mg was mixed with the PCA regimen for the RPCA group. PONV and postoperative pain were assessed.

Results

PONV incidence and scale, and Rhodes index in RPCA group between 24 and 72 h after discharge from the post-anesthetic care unit (PACU) showed significantly lower values, compared with the other groups. PONV incidence and scale, and Rhodes index in P group and R0.3 group were lower than the corresponding values in C group at all times, without statistical significance.

Conclusion

A single dose of palonosetron 75 μg or ramosetron 0.3 mg was unable to prevent PONV related to IV PCA with opioids in patients undergoing gynecological laparoscopic surgery. The combination of a single dose of ramosetron 0.3 mg, followed by ramosetron 0.6 mg mixed with PCA, significantly decreased PONV compared with a single dose of palonosetron 75 μg or ramosetron 0.3 mg.

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Acknowledgments

This research was supported by the Basic Science Research Programme through the National Research Foundation of Korea (NRF), funded by the Ministry of Education, Science and Technology (grant number: 2012R1A1A1001819). It was presented as an oral presentation in Anesthesiology™ 2014 annual meeting.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1, Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 143-729, Korea

    Seong-Hyop Kim & Chung-Sik Oh

  2. Institute of Biomedical Science and Technology, Konkuk University School of Medicine, Seoul, Korea

    Seong-Hyop Kim

  3. Department of Obstetrics and Gynecology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

    Sun Joo Lee

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  1. Seong-Hyop Kim
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  2. Chung-Sik Oh
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Correspondence to Seong-Hyop Kim.

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Kim, SH., Oh, CS. & Lee, S.J. Efficacy of palonosetron and ramosetron on postoperative nausea and vomiting related to intravenous patient-controlled analgesia with opioids after gynecological laparoscopic surgery (double-blinded prospective randomized controlled trial) . J Anesth 29, 585–592 (2015). https://doi.org/10.1007/s00540-015-1981-4

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  • DOI: https://doi.org/10.1007/s00540-015-1981-4

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