Das Sashmita, Kumar Anil, Gupta Anshu, Kumar Ajai
Anesthesiology and Critical Care, Lady Hardinge Medical College, New Delhi, IND.
Cureus. 2022 Sep 15;14(9):e29200. doi: 10.7759/cureus.29200. eCollection 2022 Sep.
Background and objective The antiemetic drug is one of the most common armamentariums in an anaesthesiologist's pharmacopoeia to prevent postoperative nausea and vomiting (PONV). PONV is one of the usual side effects after general anaesthesia, especially in female patients (21%) and after laparoscopic surgery (60%). This study aimed to compare the efficacy of ondansetron with ramosetron. Methodology After institutional ethical clearance and informed written consent, one hundred female patients scheduled for laparoscopic gynaecological surgeries were selected for this prospective, double-blinded, randomised interventional study. These patients were further subdivided into two equal groups (50 in groups R and O). Group R received ramosteron 0.3mg, and group O received ondansetron 8mg 30 minutes before the end of surgery. Patients were assessed between 0-2, 2-6, 6-12 and 12-24 hrs in the postoperative period. The primary objective of this study was to compare the effect of a single dose of ramosetron (0.3mg) with a single dose of ondansetron (8mg) for the prevention of PONV after general anaesthesia in laparoscopic surgeries. The secondary goal was to record the time of occurrence of the first episode of PONV, the need for rescue antiemetics, patient satisfaction scores, and to look for any side effects. Results This study shows no significant difference in the reduction of PONV incidence between group O and group R in the first 24 hours of the postoperative period. The overall incidence of PONV was significantly higher in the early postoperative (0-6 hrs) than in the late postoperative period (6-24 hrs), i.e., 51% and 13%, respectively. The requirement of rescue antiemetic was higher in group O than in group R but not statistically significant. In our study, both groups had similar patient satisfaction scores. Headache was the most common side effect and was noted in 9% of the patient population. Conclusion We conclude that ramosetron is as effective as ondansetron in preventing the incidence and severity of PONV up to 24 hours postoperatively.
抗呕吐药物是麻醉医生药典中最常用的药物之一，用于预防术后恶心和呕吐（PONV）。PONV是全身麻醉后常见的副作用之一，尤其是在女性患者中（发生率为21%）以及腹腔镜手术后（发生率为60%）。本研究旨在比较昂丹司琼与雷莫司琼的疗效。
经机构伦理审查并获得书面知情同意后，选择100例计划行腹腔镜妇科手术的女性患者进行这项前瞻性、双盲、随机干预研究。这些患者进一步分为两组，每组50例（R组和O组）。R组在手术结束前30分钟接受0.3mg雷莫司琼，O组接受8mg昂丹司琼。术后在0 - 2小时、2 - 6小时、6 - 12小时和12 - 24小时对患者进行评估。本研究的主要目的是比较单剂量雷莫司琼（0.3mg）与单剂量昂丹司琼（8mg）预防腹腔镜手术全身麻醉后PONV的效果。次要目标是记录PONV首次发作的时间、抢救性抗呕吐药物的使用需求、患者满意度评分，并观察任何副作用。
本研究表明，术后24小时内，O组和R组在降低PONV发生率方面无显著差异。PONV的总体发生率在术后早期（0 - 6小时）显著高于术后晚期（6 - 24小时），分别为51%和13%。O组抢救性抗呕吐药物的使用需求高于R组，但无统计学意义。在我们的研究中，两组患者满意度评分相似。头痛是最常见的副作用，在9%的患者中出现。
我们得出结论，雷莫司琼在预防术后24小时内PONV的发生率和严重程度方面与昂丹司琼效果相当。
