A COMPARATIVE STUDY OF ONDANSETRON WITH RAMOSETRON IN PREVENTION OF POST-OPERATIVE NAUSEA AND VOMITING IN PATIENTS UNDERGOING GENERAL ANESTHESIA

Authors

  • Ramakrishna Bandaru Mallareddy Institute of Medical Sciences, Hyderabad, Telangana
  • Pramila T Viswabharathi Medical College, Kurnool
  • Prathibha T Government Engineering College, Ramanagara, Karnataka
  • surendra BV viswabharathi medical college

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i10.48595

Keywords:

Ondansetron, Ramosetron, Post-operative nausea, vomiting

Abstract

Objective: Post-operative nausea and vomiting (PONV) is an unpleasant, distressing, and exhausting experience for patients. PONV may prolong recovery, delay patient discharge, and increase hospital costs. Prevention and treatment of PONV help to accelerate post-operative recovery and increase patient satisfaction. In this study, we compared the efficacy of Ondansetron and Ramosetron to prevent PONV in patients undergoing elective surgeries under general anaesthesia and also to study their side effects.

Methods: Eighty patients (American Society of Anesthesiologists [ASA] I and II) between the age group of 18 and 65 years scheduled to undergo elective surgeries under general anaesthesia were randomly allocated into two groups. Group O received Ondansetron 4 mg and Group R received Ramosetron 0.3 mg intravenously before induction of anaesthesia. Episodes of nausea, vomiting, and retching were determined and noted in first 24 h after surgery at time intervals of 0–3 h, 3–6 h, 6–12 h, and 12–24 h. The incidence of adverse effects and the use of rescue anti-emetics were also noted in the post-operative period. At the end of the surgery, results were compiled and statistical analysis was done using Student’s “t” test and Chi-square test. p<0.05 was considered as significant.

Results: The incidence of nausea was lower in patients receiving Ramosetron when compared to patients receiving Ondansetron especially in the 0–3 h period (p=0.032). This was statistically significant. The incidence nausea was lower in Group R during 3–6 h, 6–12 h, and 12–24 h period which was not statistically significant (p=1.000, p=0.359, p=1.000 respectively). The incidence of vomiting was lower in patients receiving Ramosetron when compared to patients receiving Ondansetron in the 0–3 h, 3–6 h, 6–12 h, and 12–24 h period, but it was not statistically significant (p=0.712, p=1.000, p=0.241, and p=0.116, respectively). The use of rescue anti-emetics and the incidence of adverse side effects were more in patients receiving Ondansetron when compared to patients receiving Ramosetron with no significance.

Conclusion: Our study concludes that ramosetron was more effective than ondansetron in the prevention of post-operative nausea and was associated with fewer side effects comparatively.

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Author Biographies

Ramakrishna Bandaru, Mallareddy Institute of Medical Sciences, Hyderabad, Telangana

Assistant Professor, Dept. of Anaesthesia

 

Pramila T, Viswabharathi Medical College, Kurnool

Associate Professor, Dept. of Physiology

 

Prathibha T, Government Engineering College, Ramanagara, Karnataka

Assistant Professor, Dept. of CS & E

 

References

Cohen MM, Duncan PG, DeBoer DP, Tweed WA. The postoperative interview: Assessing risk factors for nausea and vomiting. Anesth Analg 1994;78:7-16. doi: 10.1213/00000539-199401000-00004, PMID 8267183

Apfel CC, Läärä E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: Conclusions from cross-validations between two centers. Anesthesiology 1999;91:693-700. doi: 10.1097/00000542-199909000- 00022, PMID 10485781

Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg 1999;89:652-8. doi: 10.1097/00000539-199909000-00022, PMID 10475299

Gupta KC, Mehta N, Malhotra K, Matto J. Comparative study of ondansetron, granisetron and ramosetron for prevention of postoperative nausea and vomiting (PONV) in surgeries under general anaesthesia. Indian J Basic Appl Med Res 2014;3:701-5.

Apfel CC, Heidrich FM, Jukar-Rao S, Jalota L, Hornuss C, Whelan RP, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth 2012;109:742-53. doi: 10.1093/bja/aes276, PMID 23035051

Horn CC, Wallisch WJ, Homanics GE, Williams JP. Pathophysiological and neurochemical mechanisms of postoperative nausea and vomiting. Eur J Pharmacol 2014;722:55-66. doi: 10.1016/j.ejphar.2013.10.037, PMID 24495419

Moon YE. Postoperative nausea and vomiting. Korean J Anesthesiol 2014;67:164-70. doi: 10.4097/kjae.2014.67.3.164, PMID 25302092

Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology 1992;77:162-84. doi: 10.1097/00000542-199207000-00023, PMID 1609990

Habib AS, Gan TJ. Evidence-based management of postoperative nausea and vomiting: A review. Can J Anaesth 2004;51:326-41. doi: 10.1007/BF03018236, PMID 15064261

Doggrell SA, Hancox JC. Cardiac safety concerns for ondansetron, an antiemetic commonly used for nausea linked to cancer treatment and following anaesthesia. Expert Opin Drug Saf 2013;12:421-31. doi: 10.1517/14740338.2013.780026, PMID 23578248

Rabasseda X. Ramosetron, a 5-HT3 receptor antagonist for the control of nausea and vomiting. Drugs Today (Barc) 2002;38:75-89. doi: 10.1358/dot.2002.38.2.820104, PMID 12532186

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. doi: 10.1254/jjp.78.381, PMID 9869273

Bermudez J, Boyle EA, Miner WD, Sanger GJ. The anti-emetic potential of the 5-hydroxytryptamine3 receptor antagonist BRL 43694. Br J Cancer 1988;58:644-50. doi: 10.1038/bjc.1988.277, PMID 2851311

Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg 2006;102:1884-98.

Bunce KT, Tyers MB. The role of 5-HT in postoperative nausea and vomiting. Br J Anaesth 1992;69(Suppl 1):60S-2. doi: 10.1093/bja/69. supplement_1.60S

Zofran Tablets Package Insert (Cerenex-US). Rev Vols. 4/94 [rec 7/19/94].

Doo AR, Oh SM, Kim BG, Ko S. Comparison of prophylactic anti-emetic effects of ramosetron between single bolus administration and continuous infusion following bolus administration. Anesth Pain Med 2016;11:166-71. doi: 10.17085/apm.2016.11.2.166

Ansari MM, Siddiqui OA, Haleem S, Varshney R, Akhtar S, Khan FA. Comparison of ramosetron and ondansetron for control of post-operative nausea and vomiting following laparoscopic cholecystectomy. Indian J Med Sci 2010;64:272-80. doi: 10.4103/0019-5359.99606, PMID 22885319

Hahm TS, Ko JS, Choi SJ, Gwak MS. Comparison of the prophylactic anti-emetic efficacy of ramosetron and ondansetron in patients at high-risk for postoperative nausea and vomiting after total knee replacement. Anaesthesia 2010;65:500-4. doi: 10.1111/j.1365-2044.2010.06310.x, PMID 20337618

Joo J, Park S, Park HJ, Shin SY. Ramosetron versus Ondansetron for postoperative nausea and vomiting in strabismus surgery patients. BMC Anesthesiol 2016;16:41. doi: 10.1186/s12871-016-0210-5, PMID 27449404

Ryu J, So YM, Hwang J, Do SH. Ramosetron versus ondansetron for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Surg Endosc 2010;24:812-7. doi: 10.1007/s00464- 009-0670-5, PMID 19707823

Kumar R, Kumar V, Priya N. Post-operative nausea and vomiting: Comparison of the role of ramosetron and ondansetron. Int J Sci Study 2016;4:106-9.

Published

07-10-2023

How to Cite

Ramakrishna Bandaru, Pramila T, Prathibha T, and surendra BV. “A COMPARATIVE STUDY OF ONDANSETRON WITH RAMOSETRON IN PREVENTION OF POST-OPERATIVE NAUSEA AND VOMITING IN PATIENTS UNDERGOING GENERAL ANESTHESIA”. Asian Journal of Pharmaceutical and Clinical Research, vol. 16, no. 10, Oct. 2023, pp. 182-5, doi:10.22159/ajpcr.2023.v16i10.48595.

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