Comparison of ramosetron and ondansetron for prevention of nausea and vomiting after carboprost in LSCS patients under spinal anesthesia

Dinesh Chauhan, Mrugank Bhavsar

Abstract


Background: Our aim of the study is to compare the effectiveness of ramosetron and ondansetron to prevent postoperative nausea and vomiting with carboprost in LSCS patients operated under spinal anesthesia.

Methods: 50 patients of age group 20-35 years and ASA physical status of grade I and II scheduled for LSCS with use of carboprost IM under spinal anesthesia. They were randomly allocated into two groups namely group O and group R. inj. ondansetron 4 mg and inj. ramosetron 0.3 mg IV respectively. Patients were observed intraoperatively and in the recovery room and ward for any episodes of nausea and vomiting. Rescue antiemetic was given if the patient had PONV score of 2 and was also recorded. All the patients were observed for side effects such as dizziness, headache, sedation or extrapyramidal reaction and treated accordingly upto 24 hours.

Results: Incidence of nausea in immediate postoperative period was 8 % in group R compared to 20% in group O. Requirement of rescue antiemetic was minimum, i.e., 4% in group R. Incidence of side effects (headache, constipation and dizziness) was comparable in both the groups.

Conclusions: Ramosetron is quite effective to prevent postoperative nausea and vomiting with carboprost in LSCS patients. It also reduces incidence of nausea in immediate postoperative period.


Keywords


Ramosetron, Ondansetron, Spinal anesthesia, LSCS

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References


Scuderi PE, Conlay LA. Post-operative nausea and vomiting and outcome. Int Anesthesiol Clin. 2003;41:165-74.

K. D. Tripathi. Prostaglandins leukotrienes (eicosanoids) and platelet activating factor. In: 2. K. D. Tripathi, eds. Essentials of Medical Pharmacology. 6th ed. New Delhi: Jaypee Brothers Medical Publishers; 2009: 174-181.

Watcha MF, White PF. Post-operative nausea and vomiting. Its etiology, treatment and prevention. Anesthesiol. 1992;77:162-84.

Mckenzia R, Kovac A, O'Conney T et al. Comparison of ondansatron verses placebo to prevent post-operative nausea and vomiting in women undergoing ambulatory gynecological surgery. Anesthesiol. 1993;78:21-8.

Lai N, Khan MN, Qureshi FA, et al. Dexamethasone as an antiemetic during gynecological laparoscopic surgery. J Coll Physicians Surg Park. 2005;15(12):778-81.

Rabasseda X. Ramosetron, a 5-HT3 receptor antagonist for the control of nausea and vomiting. Drugs Today. 2002;38:75-89.

Akuzawa S, Ito H, Yamaguchi T. Comparative study of [3H] ramosetron and [3H] granisetron binding in the cloned human 5-hydroxytryptamine3 receptors. Jpn J Pharmacol. 1998;78:381-4.

Kang YK, Park YH, Ryoo BY et al. Ramosetron for the prevention of cisplatin-induced acute emesis: a prospective randomized comparison with granisetron. J Int Med Res. 2002;30:220-9.

Feng FY, Zhang P, He YJ, et al. Comparison of the selective serotonin3 antagonists ramosetron and granisetron in treating acute chemotherapy induced emesis, nausea, and anorexia: a single blind, randomized, crossover study. Curr Ther Res. 2000;61:901-9.

Fujii Y, Saitoh Y, Tanaka H, Toyooka H. Comparison of ramosetron and granisetron for preventing postoperative nausea and vomiting after gynecologic surgery. Anesth Analg. 1999;89:476-9.

Choi YS, Shim JK, Yoon do H, Jeon DH, Lee JY, Kwak YL. Effect of ramosetron on patient-controlled analgesia related nausea and vomiting after spine surgery in highly susceptible patients: comparison with ondansetron. Spine. 2008;33:E602-6.

Fujii Y, Saitoh Y, Tanaka H, Toyooka H. Ramosetron for preventing postoperative nausea and vomiting in women undergoing gynecological surgery. Anesth Analg. 2000;90:472-5.

Fujii Y, Tanaka H. Double-blind, placebo-controlled, dose-ranging study of ramosetron for the prevention of nausea and vomiting after thyroidectomy. Clin Ther 2002; 24: 1148–53

S. I. Kim, S. C. Kim, Y. H. Baek, S. Y. Ok and S. H. Kim. Comparison of ramosetron with ondansetron for prevention of postoperative nausea and vomiting in patients undergoing gynaecological surgery. Br J Anesth. 2009;103(4):549-53.

McKenzie R, Kovac A, O’Connor T et al. Comparison of ondansetron versus placebo to prevent postoperative nausea and vomiting in women undergoing ambulatory gynecologic surgery. Anesthesiol. 1993;78:21-8.