Ramosetron, dexamethasone, and their combination for the prevention of postoperative nausea and vomiting in women undergoing laparoscopic cholecystectomy

BACKGROUND: In this randomized and controlled study, we evaluated the antiemetic efficacy of ramosetron combined with dexamethasone for postoperative nausea and vomiting (PONV) compared with that of dexamethasone or ramosetron alone in women who underwent laparoscopic cholecystectomy. METHODS: One hundred twenty female patients were randomly assigned to one of three groups to receive antiemetics as follows: ramosetron 0.3 mg (group R), dexamethasone 8 mg (group D), or ramosetron 0.3 mg combined with dexamethasone 8 mg (group RD). PONV, postoperative pain intensity, rescue antiemetics requirement, and side effects were assessed at 0-6, 6-12, and 12-24 h after surgery. RESULTS: The ratio of complete response (no PONV and no rescue antiemetic) was higher at 6-12 h in groups R and RD than in group D (p < 0.05) and at 12-24 h in group RD than in group D (p < 0.05). The incidence of nausea was lower at 6-12 h in groups R (p = 0.043) and RD (p = 0.003) compared to group D and at 12-24 h in group RD (p = 0.01) compared to group D. The severity of nausea was also significantly reduced at 6-12 h in groups R and RD compared to group D (p < 0.05). There were no clinically serious adverse events related to the studied drugs. CONCLUSION: Antiemetic efficacy of the combination of ramosetron 0.3 mg and dexamethasone 8 mg for PONV was most superior, with 93% of the patients showing complete response at 12-24 h after surgery followed by ramosetron alone and dexamethasone alone.ope