Ramosetron, midazolam, and combination of ramosetron and midazolam for prevention of postoperative nausea and vomiting: a prospective, randomized, double-blind study.

Won Joong Kim, Hyun Kang, Hwa Yong Shin, Chong Wha Baek, Yong Hun Jung, Young Cheol Woo, Jin Yun Kim, Gil Hoi Koo

Index: J. Int. Med. Res. 41(4) , 1203-13, (2013)

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Abstract

To compare the efficacy of ramosetron, midazolam, and the combination of ramosetron and midazolam in the prevention of postoperative nausea and vomiting (PONV) in female patients undergoing thyroidectomy.Patients were randomized to receive 0.3 mg ramosetron (Group R), 75 µg/kg midazolam (Group M) or 0.3 mg ramosetron combined with 75 µg/kg midazolam (Group RM) before the induction of anaesthesia. PONV, use of rescue antiemetics, pain severity and fentanyl consumption were assessed for 24 h after thyroidectomy.A total of 100 patients were enrolled; 94 patients completed the study. The severity of nausea was statistically significantly reduced at 0-2 h in Group RM compared with Groups R and M, and at 2-6 h in Group RM compared with Group M. The incidence of retching and vomiting was significantly lower at 0-2 h, 2-6 h, 6-12 h in Group RM than in Group M, and lower in Group R than Group M at 6-12 h. The requirement for rescue antiemetics was significantly lower at 0-2 h in group RM than in group M.The combination therapy of ramosetron and midazolam provided superior antiemetic efficacy compared with midazolam single therapy, but did not show any significant additional benefits compared with ramosetron single therapy.