Effect of ramosetron on patient-controlled analgesia related nausea and vomiting after spine surgery in highly susceptible patients

Comparison with ondansetron

Yong Seon Choi, Jae Kwang Shim, Do Heum Yoon, Duck Heeh Jeon, Ji Yeon Lee, Younglan Kwak

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

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.

Original languageEnglish
JournalSpine
Volume33
Issue number17
DOIs
Publication statusPublished - 2008 Aug 1

Fingerprint

Ondansetron
Patient-Controlled Analgesia
Nausea
Vomiting
Spine
Postoperative Nausea and Vomiting
Incidence
Opioid Analgesics
Receptors, Serotonin, 5-HT3
Fentanyl
Pain
Early Ambulation
Antiemetics
ramosetron
Pain Management
Postoperative Pain
Analgesia
Analgesics
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

@article{92c80b8e7c9f40aabd1f24029d67215b,
title = "Effect of ramosetron on patient-controlled analgesia related nausea and vomiting after spine surgery in highly susceptible patients: Comparison with ondansetron",
abstract = "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.",
author = "Choi, {Yong Seon} and Shim, {Jae Kwang} and Yoon, {Do Heum} and Jeon, {Duck Heeh} and Lee, {Ji Yeon} and Younglan Kwak",
year = "2008",
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language = "English",
volume = "33",
journal = "Spine",
issn = "0362-2436",
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Effect of ramosetron on patient-controlled analgesia related nausea and vomiting after spine surgery in highly susceptible patients : Comparison with ondansetron. / Choi, Yong Seon; Shim, Jae Kwang; Yoon, Do Heum; Jeon, Duck Heeh; Lee, Ji Yeon; Kwak, Younglan.

In: Spine, Vol. 33, No. 17, 01.08.2008.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of ramosetron on patient-controlled analgesia related nausea and vomiting after spine surgery in highly susceptible patients

T2 - Comparison with ondansetron

AU - Choi, Yong Seon

AU - Shim, Jae Kwang

AU - Yoon, Do Heum

AU - Jeon, Duck Heeh

AU - Lee, Ji Yeon

AU - Kwak, Younglan

PY - 2008/8/1

Y1 - 2008/8/1

N2 - 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.

AB - 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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