Document Detail


Effect of ramosetron on patient-controlled analgesia related nausea and vomiting after spine surgery in highly susceptible patients: comparison with ondansetron.
MedLine Citation:
PMID:  18670328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Yong Seon Choi; Jae Kwang Shim; Do Heum Yoon; Duck Heeh Jeon; Ji Yeon Lee; Young Lan Kwak
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Spine     Volume:  33     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-01     Completed Date:  2009-01-28     Revised Date:  2014-03-11    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E602-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
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:
0/Benzimidazoles; 4AF302ESOS/Ondansetron; 7ZRO0SC54Y/ramosetron

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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