Comparison of ramosetron plus dexamethasone with ramosetron alone in the prevention of nausea and vomiting after gynecologic laparoscopic surgery

Abstract

Background: Postoperative nausea and vomiting (PONV) is extremely distressing and uncomfortable, and is noted frequently in patients who have undergone gynecologic laparoscopic surgery. In this study, we compared the efficacy of a combination of ramosetron plus dexamethasone and ramosetron alone in reducing of PONV after gynecologic laparoscopic surgery.

Methods: Sixty patients who received gynecologic laparoscopic surgery were randomly divided into two groups: the R group (ramosetron 0.3 mg) and RD group (ramosetron 0.3 mg plus dexamethasone 5 mg). Dexamethasone, 5 mg, or saline, 1 ml, was administered randomly before the induction of anesthesia in each group. The two groups received intravenous ramosetron, 0.3 mg, at the end of surgery. General anesthesia was induced using thiopental and rocuronium, and maintained with sevoflurane in nitrous oxide. The incidence and severity of nausea, frequency of vomiting and rescue medication, VAS score, and adverse events were evaluated for 48 hours after the operation.

Results: In the first 12 hours after operation, the incidence of PONV in the RD group (33%) was significantly lower than the R group (67%; P < 0.05). However, there were no significant differences between two groups in PONV incidence 12-48 h postoperatively. Adverse events and VAS scores were similar in the two groups.

Conclusions: The combination of ramosetron plus dexamethasone is superior to ramosetron alone for prevention of PONV during the first 12 hours after gynecologic laparoscopic surgery.

Keywords: Dexamethasone; Gynecologic laparoscopic surgery; Postoperative nausea and vomiting; Ramosetron.