Comparison of the efficacy of ramosetron and ondansetron in the prophylaxis of postoperative vomiting in children receiving fentanyl by patient-controlled analgesia after orthopedic surgery: a randomized controlled trial

Paediatr Anaesth. 2013 Apr;23(4):360-4. doi: 10.1111/pan.12103. Epub 2013 Jan 2.

Abstract

Background: This study was designed to compare the efficacy of prophylactic ramosetron and ondansetron in preventing postoperative vomiting in children who received fentanyl by patient-controlled analgesia after orthopedic surgery.

Methods: Two hundred and eighteen children, 2-15 years old, ASA physical status 1 or 2, scheduled for elective orthopedic surgeries, were randomly divided into the ramosetron group (n = 109) or ondansetron group (n = 109). Patients in ondansetron group received ondansetron 100 μg·kg(-1) and patients in ramosetron group received ramosetron 6 μg·kg(-1) after surgery. Intravenous patient-controlled analgesia with fentanyl was used in both groups. The incidence of postoperative vomiting and side effects were assessed during the 48 h after surgery.

Results: There was significantly less vomiting during the first 24-h and 6-24-h period after surgery in ramosetron group than in ondansetron group (P < 0.01). There were no significant differences in side effect of 5-HT(3) antagonist between the two groups.

Conclusion: Ramosetron was more effective during the first 24-h period after surgery than ondansetron in children using fentanyl patient-controlled analgesia after general anesthesia.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Analgesia, Patient-Controlled / adverse effects*
  • Analgesics, Opioid / adverse effects*
  • Analgesics, Opioid / therapeutic use
  • Antiemetics / adverse effects
  • Antiemetics / therapeutic use*
  • Benzimidazoles / adverse effects
  • Benzimidazoles / therapeutic use*
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Female
  • Fentanyl / adverse effects*
  • Fentanyl / therapeutic use
  • Humans
  • Male
  • Ondansetron / adverse effects
  • Ondansetron / therapeutic use*
  • Orthopedic Procedures / methods*
  • Pain, Postoperative / complications*
  • Pain, Postoperative / drug therapy
  • Postoperative Nausea and Vomiting / prevention & control*

Substances

  • Analgesics, Opioid
  • Antiemetics
  • Benzimidazoles
  • Ondansetron
  • ramosetron
  • Fentanyl