Background: Ramosetron is a new selective 5-hydroxytryptamine type 3 (5HT₃) receptor antagonist that reportedly has more potent antiemetic effects compared with other 5HT₃ receptor antagonists. The purpose of this study was to evaluate the efficacy of Ramosetron for the prevention of postoperative nausea and vomiting (PONV) with that of Ondansetron in patients undergoing gynecological surgery.

Materials and Methods: In this prospective study, 50 healthy patients who were undergoing gynecological operation under general anaesthesia using sevoflurane were enrolled. Patients were divided into two groups: the Ramosetron group (0.3 mg i.v.; n=25) and the Ondansetron group (8 mg i.v.; n=25). The treatments were given 30 minutes before the end of surgery. The incidence of PONV, severity of nausea, and the use of rescue antiemetic requirements during the first 24 h after surgery were evaluated as two groups (0-6 hours and 6-24 hours).

Results: The incidence of nausea in the first 6 hours after the surgery in the Ramosetron and Ondansetron groups was 4% & 20% respectively, which was statistically insignificant where as late nausea (6-24 hrs) was 12% and 40% which was statistically significant. 2 patients in the Ondansetron group and none in the Ramosetron group had vomiting during the first 6 hours, which was statistically insignificant, whereas none in the Ramosetron group and 32% of patients in Ondansetron group had vomiting during the late postoperative period of 6-24 hours which was statistically significant.

Conclusions: So it was concluded that Ramosetron 0.3 mg i.v. was as effective as Ondansetron 8 mg i.v. in decreasing the incidence of PONV and reducing nausea severity in female patients during the first 6 h after gynecological surgery but Ramosetron was found to be more effective than Ondansetron in prevention of PONV in the 6-24 hours period after the surgery.

Keywords: Ramosetron, Ondansetron, Nausea, vomiting.

1.      Shevde K, Panagopoulos G: A survey of 800 patients knowledge, attitudes, and concerns regarding anesthesia. Anesth Analg 1991; 73:190

2.      Andrews PLR. Physiology of nausea and vomiting. Br J Anesth 1992, 69 Suppl 1: 2 - 19.

3.      Katzung BG, Master SB, Trevor AJ : basic and clinical pharmacology, 12th edition

4.      Kenny GNC. Risk factors for postoperative nausea and vomiting. Br J Anaesth1992; 49 Suppl 1: 6 - 10.

5.      PA. The big “little problem”. AnesthAnalg 1991; 73: 243 - 45.

6.      Gan TJ, Meyer T, Apfel CC, et al. Consensus guidelines for managing postoperative nausea and vomiting. AnesthAnalg 2003; 97: 62 – 71 5

7.      Koivuranta M, La¨a¨ra¨ E, Ranta P, Ravaska P, Alahuhta S. Comparison of ondansetron and droperidol in the prevention of postoperative nausea and vomiting after laparoscopic surgery in women. A randomised, double-blind, placebo-controlled trial. Acta Anaesthesiol Scand 1997; 41: 1273 – 9 6

8.      Sadhasivam S, Saxena A, Kathirvel S, Kannan TR, Trikha A, Mohan V. The safety and efficacy of prophylactic ondansetron in patients undergoing modified radical mastectomy. AnesthAnalg 1999; 89: 1340 – 5 7

9.      McKenzie R, Kovac A, O’Connor T, et al. Comparison of ondansetron versus placebo to prevent postoperative nausea and vomiting in women undergoing ambulatory gynecologic surgery. Anesthesiology 1993; 78: 21 – 8

10.  Kim SI, Kim SC, Baek YH, Ok SY, Kim SH,Comparison of Ramosetron with Ondansetron for prevention of postoperative nausea and vomiting in patients undergoing gynecological surgery. Br J Anaesth. 2009 Oct;103(4):549-53.

11.  Ryu J, So YM, Hwang J, Do SH, Ramosetron versus Ondansetron for the prevention of postoperative nausea and vomiting after laparoscopic cholecyst-ectomy. Surg Endosc. 2010 Apr;24 (4):812-7.

12.  Swailka S, Pal A, Chaterjee S, Saha D, Dawar N. Ondansetron, Ramosetron, or Palonosetron: Which is a better choice of antiemetic to prevent postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy?. Anest Essays Res 2011; 182-6

Dr Abhimanyu Singh

Associate professor, Department of Anesthesiology

Government Siddhartha Medical College, Vijayawada,

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