Oral Ramosetron in Combination with Dexamethasone Versus Oral Ramosetron Alone for Post Operative Nausea and Vomiting: A Randomized Controlled Trial

Julius Robert  B. Guerrero,; Elena  B. Realubit,; Monique  M. Yoingco,; Ma. Lilybeth  R. Tanchoco,

Oral Ramosetron in Combination with Dexamethasone Versus Oral Ramosetron Alone for Post Operative Nausea and Vomiting: A Randomized Controlled Trial

Julius Robert B. Guerrero | Elena B. Realubit | Monique M. Yoingco | Ma. Lilybeth R. Tanchoco

Abstract:

Objective: To compare the therapeutic efficacy of a preoperative single administration of long-acting 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist (Ramosetron) in an orally disintegrating tablet formulation alone versus the effects of oral ramosetron with dexamethasone in post operative nausea and vomiting.

Setting: Tertiary Hospital

Sample Population and Methodology: Sixty patients, ASA I-II, aged 21-80 years old, undergoing elective surgery, were included in the study. They were randomly assigned to preoperative antiemetic prophylaxis regimen (A: Ramosetron with Dexamethasone [n=30] and B: Ramosetron alone [n=30]). Anesthetic technique used was general anesthesia. Three hours before the surgical procedure, all patients were given oral ramosetron 100 mcg. Those patients assigned to the ramosetron and dexamethasone group were given intravenous Dexamethasone at cutting time. Postoperative analgesic management was standardized in all patients. Postoperative variables were collected in the recovery room (2 and 4 hours after the end of anesthesia) and in the ward (6, 12, and 24 hours after recovery from anesthesia). Episodes of nausea and vomiting were recorded.

Results: Thirty subjects were assigned to each group. Two patients in each group complained of nausea at 4 and 6 hours post anesthesia. Vomiting at 4 and 6 hours post anesthesia was reported by 2 patients in the Ramosetron with Dexamethasone group. Statistical analysis revealed that there was no significant difference in the efficacy of the two regimens as proven (p value >0.05).

Conclusion: Postoperative nausea and vomiting was lessened in both prophylactic antiemetic regimens. However, there was no significant difference in the prevention of postoperative nausea and vomiting in patients given oral Ramosetron with Dexamethasone versus Ramosetron alone.