Abstract | STUDY DESIGN: A prospective, randomized, and double-blind study. OBJECTIVE: SUMMARY OF BACKGROUND DATA: IV-PCAopioid, an effective method to control pain after lumbar spinal surgery, accompanies PONV. Ramosetron and palonosetron are novel 5-hydroxytryptamine 3 antagonists known to have longer action duration and higher receptor affinity than their congeners, whereas their relative efficacy has not been validated yet. METHODS: One hundred ninety-six patients were randomly and evenly allocated to receive either 0.3 mg of ramosetron or 0.075 mg of palonosetron 10 minutes before the end of operation. Ramosetron or palonosetron were also added to the IV-PCAopioid, which was continuously infused for 48 hours postoperatively. The incidence and intensity of PONV were serially assessed for 72 hours postoperatively. Intensity of pain, volume of IV-PCAopioid consumption, use of rescue analgesics and antiemetics, and adverse events were also assessed. RESULTS: The overall incidence of PONV was lower in the ramosetron group than the palonosetron group (50% vs. 67%, P = 0.014) without any intergroup difference in the incidence of vomiting. Nausea intensity scores were also lower until 6 (P = 0.041) and 24 hour (P = 0.026) postoperatively in the ramosetron group than the palonosetron group. Pain intensity scores were significantly lower in the ramosetron group than the palonosetron group for 72 hours postoperatively. CONCLUSION: LEVEL OF EVIDENCE: 1.
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Authors | Go Un Roh, So Young Yang, Jae Kwang Shim, Young Lan Kwak |
Journal | Spine
(Spine (Phila Pa 1976))
Vol. 39
Issue 9
Pg. E543-9
(Apr 20 2014)
ISSN: 1528-1159 [Electronic] United States |
PMID | 24480956
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Analgesics, Opioid
- Antiemetics
- Benzimidazoles
- Isoquinolines
- Quinuclidines
- Palonosetron
- ramosetron
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Topics |
- Adult
- Aged
- Analgesics, Opioid
(adverse effects, therapeutic use)
- Antiemetics
(therapeutic use)
- Benzimidazoles
(therapeutic use)
- Double-Blind Method
- Female
- Humans
- Isoquinolines
(therapeutic use)
- Lumbar Vertebrae
(surgery)
- Male
- Middle Aged
- Orthopedic Procedures
(adverse effects)
- Pain Management
- Palonosetron
- Postoperative Nausea and Vomiting
(chemically induced, drug therapy, prevention & control)
- Prospective Studies
- Quinuclidines
(therapeutic use)
- Treatment Outcome
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