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Original Research Article Background: Postoperative nausea and vomiting (PONV) is a very common and distressing complication after anaesthesia and surgery and 60-80% of patients who undergo middle ear surgery experience this complication. The multifactorial nature of PONV have hampered development of an effective antiemetic therapy and the 5Hydroxytryptamine (5-HT3) receptor antagonists are currently recommended as the agents of first choice to prevent PONV. Ramosetron is a relatively new, selective 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist that reportedly has more potent antiemetic effects compared with other 5-HT3 receptor antagonists. The purpose of this study was to evaluate and compare the efficacy of ramosetron for the prevention of postoperative nausea and vomiting (PONV) with that of Ondansetron in patients undergoing middle ear surgery after general anaesthesia. Objective: To compare the antiemetic efficacy of prophylactic Ondansetron with Ramosetron. Methods: In this prospective, randomized, double-blinded study, 96 patients of either sex, aged 18-60 years of ASA physical status I and II, who were undergoing middle ear surgery under general anaesthesia were enrolled. Patients were divided into two groups: the Ramosetron group (0.3 mg i.v.; n=48), the Ondansetron group (4 mg i.v.; n=48). The incidence of PONV, severity of nausea, and the use of rescue antiemetic requirements during the first 48 h after surgery in intervals 0,6,12,24,36,48 hours were evaluated. Statistical Analysis and Results: Single dose of Ramosetron (0.3mg) was found to be overall more effective than single dose of Ondansetron (4mg) in prevention of postoperative nausea and vomiting in patients undergoing middle ear surgery following general anaesthesia. Statistically significant difference between Groups A and B (P<0.05) was found in the time period 24-48hrs post operatively showing that Ramosetron was superior to Ondansetron as antiemetic both regarding frequency and severity. Conclusion: It was evident that prophylactic administration of single dose IV Ramosetron (0.3 mg) has better efficacy than single dose IV Ondansetron (4 mg) in reducing the episodes of PONV over 48 hours postoperatively in patients undergoing middle ear surgery under general anaesthesia.

sas journal of medicine

Efficacy of Ramosetron and Ondansetron in Preventing Postoperative Nausea and Vomiting in Patients Undergoing Middle Ear Surgery Following General Anasethesia: A Prospective, Randomized, Double Blind Study