| Effect of ramosetron on patient-controlled analgesia related nausea and vomiting after spine surgery in highly susceptible patients: comparison with ondansetron. | |
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MedLine Citation:
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PMID: 18670328 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: A prospective, randomized, double-blind clinical trial. OBJECTIVE: To compare the effect of ramosetron with that of ondansetron on opioid-based IV patient-controlled analgesia (PCA) related postoperative nausea and vomiting (PONV) in highly susceptible patients after lumbar spine surgery. SUMMARY OF BACKGROUND DATA: Optimal postoperative pain management is important to facilitate early mobilization after lumbar spine surgery. Opioid analgesia is associated with a high incidence of PONV. Among the currently available 5-hydroxytryptamine receptor 3 antagonists (5-HT3), ondansetron is being most widely used with unsatisfactory results regarding opioid-based IV PCA related PONV. Ramosetron is a newly developed 5-HT3 antagonist with higher receptor affinity and longer duration of action having theoretical advantage over ondansetron in this setting. However, data to support this view are lacking. METHODS: All 94 female nonsmoker patients (aged 18-65 years) were randomly allocated into either ondansetron group (group O, n = 47) or ramosetron group (group R, n = 47). Fentanyl-based IV PCA was administered for 48 hours after surgery. Overall incidence and severity of nausea and incidence of vomiting were assessed for 48 hours after surgery. Secondary measures included: pain intensity and total amount of administered rescue analgesic. RESULTS: Patients' characteristics were similar between the groups. Overall incidence of nausea was similar between the groups; however, moderate to severe degree of nausea was significantly more in the group O (34%) than in the group R (13%) 6 to 24 hours after surgery. Overall incidence of vomiting and use of rescue antiemetic 6 to 24 hours after surgery was significantly lower in the group R (30% vs. 11% and 28% vs. 11%, respectively). Pain scores at 24 to 48 hours after surgery were significantly lower in the group R (31 +/- 25 vs. 13 +/- 15). CONCLUSION: Ramosetron was superior to ondansetron in terms of preventing vomiting and reducing the severity of nausea related to fentanyl-based IV PCA, with less adverse events, in patients with high susceptibility, undergoing lumbar spine surgery. |
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Authors:
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Yong Seon Choi; Jae Kwang Shim; Do Heum Yoon; Duck Heeh Jeon; Ji Yeon Lee; Young Lan Kwak |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Spine Volume: 33 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-08-01 Completed Date: 2009-01-28 Revised Date: 2009-07-09 |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: E602-6 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Analgesia, Patient-Controlled / adverse effects*, methods Benzimidazoles / therapeutic use* Double-Blind Method Female Humans Middle Aged Ondansetron / therapeutic use* Postoperative Nausea and Vomiting / etiology, prevention & control* Prospective Studies Spinal Diseases / drug therapy, surgery |
| Chemical | |
Reg. No./Substance:
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0/Benzimidazoles; 132907-72-3/ramosetron; 99614-02-5/Ondansetron |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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