Journal
JOURNAL OF ANESTHESIA
Volume 29, Issue 4, Pages 585-592Publisher
SPRINGER JAPAN KK
DOI: 10.1007/s00540-015-1981-4
Keywords
Postoperative nausea and vomiting; Patient-controlled analgesia; Opioids
Categories
Funding
- National Research Foundation of Korea (NRF) - Ministry of Education, Science and Technology [2012R1A1A1001819]
- National Research Foundation of Korea [2012R1A1A1001819] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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The study was designed to assess the efficacy of palonosetron and ramosetron in preventing postoperative nausea and vomiting (PONV) related to intravenous (IV) patient-controlled analgesia (PCA) with opioids after gynecological laparoscopic surgery. Patients were randomly allocated to 4 groups-C, P, R0.3 and R-PCA. At the end of surgery, group C received an infusion of 50 ml normal saline, group P received palonosetron 75 mu g mixed in 50 ml normal saline, and groups R0.3 and R-PCA received ramosetron 0.3 mg mixed in 50 ml normal saline. A PCA pump containing fentanyl was connected for all groups; however, ramosetron 0.6 mg was mixed with the PCA regimen for the R-PCA group. PONV and postoperative pain were assessed. PONV incidence and scale, and Rhodes index in R-PCA group between 24 and 72 h after discharge from the post-anesthetic care unit (PACU) showed significantly lower values, compared with the other groups. PONV incidence and scale, and Rhodes index in P group and R0.3 group were lower than the corresponding values in C group at all times, without statistical significance. A single dose of palonosetron 75 mu g or ramosetron 0.3 mg was unable to prevent PONV related to IV PCA with opioids in patients undergoing gynecological laparoscopic surgery. The combination of a single dose of ramosetron 0.3 mg, followed by ramosetron 0.6 mg mixed with PCA, significantly decreased PONV compared with a single dose of palonosetron 75 mu g or ramosetron 0.3 mg.
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