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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.

Authors
 Yong Seon Choi  ;  Jae Kwang Shim  ;  Do Heum Yoon  ;  Duck Heeh Jeon  ;  Ji Yeon Lee  ;  Young Lan Kwak 
Citation
 SPINE, Vol.33(17) : 602-606, 2008 
Journal Title
 SPINE 
ISSN
 0362-2436 
Issue Date
2008
MeSH
Adolescent ; Adult ; Aged ; Analgesia, Patient-Controlled/adverse effects* ; Analgesia, Patient-Controlled/methods ; Benzimidazoles/therapeutic use* ; Double-Blind Method ; Female ; Humans ; Middle Aged ; Ondansetron/therapeutic use* ; Postoperative Nausea and Vomiting/etiology ; Postoperative Nausea and Vomiting/prevention & control* ; Prospective Studies ; Spinal Diseases/drug therapy ; Spinal Diseases/surgery
Keywords
Adolescent ; Adult ; Aged ; Analgesia, Patient-Controlled/adverse effects* ; Analgesia, Patient-Controlled/methods ; Benzimidazoles/therapeutic use* ; Double-Blind Method ; Female ; Humans ; Middle Aged ; Ondansetron/therapeutic use* ; Postoperative Nausea and Vomiting/etiology ; Postoperative Nausea and Vomiting/prevention & control* ; Prospective Studies ; Spinal Diseases/drug therapy ; Spinal Diseases/surgery
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.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00007632-200808010-00021&LSLINK=80&D=ovft
DOI
10.1097/BRS.0b013e31817c6bde
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Yoon, Do Heum(윤도흠) ORCID logo https://orcid.org/0000-0003-1452-5724
Lee, Ji Yeon(이지연)
Chun, Duk Hee(전덕희)
Choi, Yong Seon(최용선) ORCID logo https://orcid.org/0000-0002-5348-864X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106141
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