Preventive effect of ramosetron on patient-controlled analgesia-related nausea and vomiting after laparoscopic hysterectomy.
- Author:
Young Sun KIM
1
;
Ki Yeol YANG
;
Ok Young SHIN
;
Bo Yon LEE
;
Min Hyung JUNG
Author Information
1. Department of Obstetrics and Gynecology, School of Medicine, Kyung Hee University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Patient-controlled analgesia;
Postoperative nausea and vomiting;
5-hydroxytryptamine receptor 3;
Laparoscopic hysterectomy;
Ramosetron
- MeSH:
Analgesia;
Analgesia, Patient-Controlled;
Analgesics, Opioid;
Benzimidazoles;
Humans;
Hysterectomy;
Ileus;
Incidence;
Medical Records;
Nausea;
Ondansetron;
Postoperative Nausea and Vomiting;
Serotonin;
Uterine Diseases;
Vomiting
- From:Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery
2011;23(2):73-77
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Patient-controlled-analgesia (PCA) using intravenous (IV) opioids is recognized a safe and effective method for pain control. However, postoperative analgesia with opioids is associated with a high incidence of postoperative nausea and vomiting (PONV) exceeding 30%. The 5-hydroxytryptamine receptor 3 (5-HT3) antagonists alleviate nausea and vomiting. This study aims to compare the effectiveness of ramosetron and ondansetron in preventing PONV following laparoscopic hysterectomy for benign uterine diseases under general anesthesia. METHODS: The medical records of 1483 patients who underwent laparoscopic hysterectomy between January 2005 and May 2009 were reviewed. Of the 1483 patients, 1184 patients who received IVPCA with ramosetron 0.3 mg (n=761) or ondansetron 8 mg (n=423) were analyzed. Fentanyl-based IVPCA was administered for 48 hours after surgery. The overall incidence of postoperative nausea and vomiting, bowel ileus, Levin tube insertion for severe bowel ileus, additional usage of pain killers and discontinuation of the IVPCA infusion with PCA-related severe nausea and vomiting were assessed for 48 hours after surgery. The amount of time until bowel gas passage resumption after surgery was measured. RESULTS: There was a significant difference between the two groups regarding the duration until post-operative bowel gas passage resumption (1.78+/-0.79 days in the ramosetron group, and 2.23+/-0.83 days in the ondansetron group; p=0.005); however, there were no significant differences found in other aspects. CONCLUSION: Ramosetron is superior to ondansetron in terms of faster recovery in bowel mobility, with similar effects in preventing the incidence of PONV.
