Antiemetic Prophylaxis with Ramosetron for Postoperative Nausea and Vomiting in Patients Undergoing Microvascular Decompression : A Prospective, Randomized Controlled Trial

J Korean Neurosurg Soc. 2022 Nov;65(6):853-860. doi: 10.3340/jkns.2021.0288. Epub 2022 Apr 18.

Abstract

Objective: This prospective, randomized, double-blinded trial aimed to evaluate the efficacy and safety of prophylactic ramosetron administration against postoperative nausea and vomiting (PONV) in patients undergoing microvascular decompression (MVD).

Methods: In this study, 100 patients undergoing MVD were randomly allocated to the control (normal saline, 2 mL) or ramosetron (ramosetron, 0.3 mg) groups at the end of surgery. The incidence and severity of PONV, need for rescue antiemetics, patient satisfaction score, duration of hospital stay, and the occurrence of adverse events were evaluated 48 hours post-surgery.

Results: Data obtained from 97 patients were included in the final analysis. The incidence of PONV was significantly lower in the ramosetron group than in the control group throughout the 48-hour postoperative period (29.2% vs. 51.0%, p=0.028). A similar trend was observed with regard to PONV severity (p=0.041). The need for rescue antiemetics, satisfaction score, duration of hospital stays, and the occurrence of adverse events did not significantly differ between the groups.

Conclusion: Prophylactic ramosetron administration reduced the incidence and severity of PONV in patients undergoing MVD without causing serious adverse events. Thus, ramosetron use may improve patient recovery following MVD.

Keywords: Antiemetics; Microvascular decompression surgery; Patient-controlled analgesia; Postoperative nausea and vomiting; Ramosetron.