Abstract
BackgroundArthroscopic rotator cuff repair is a painful procedure, and treatment of emetic events associated with drugs used in the current multimodal pain management remains challenging. This study aimed to evaluate the effectiveness of ramosetron or ondansetron to relieve postoperative nausea and vomiting (PONV) and pain after arthroscopic rotator cuff repair.MethodsIn total, 122 consecutive patients undergoing arthroscopic rotator cuff repair were randomly allocated into three groups: ramosetron group (n = 39), ondansetron group (n = 43), and control group (n = 40). Then, 0.3 mg of ramosetron or 8 mg of ondansetron was administered intravenously at the end of surgery according to group. All patients received general anesthesia and multimodal pain management protocol including preemptive analgesic medication, fentanyl-based intravenous patient-controlled analgesia, and postoperative analgesic medication. Incidence of emetic events, rescue antiemetic requirements (10 mg of metoclopramide, IV), complete response, pain level, and side effects were recorded in three periods: 0–6, 6–24, and 24–48 h postoperatively. The severity of nausea and pain was evaluated using a visual analog scale.ResultsThe ramosetron group tended to have a lower incidence and severity of nausea during the 6- to 24-h postoperative period and fewer rescue antiemetic drug requirements during the 0- to 48-h period than the control group, showing statistical significance. Additionally, the frequency of complete response of the ramosetron and ondansetron groups was significantly higher than that of the control group. No difference was found among the groups in the pain level except during the 0- to 6-h period. The two groups have a higher complete response during the 6- to 24-h period than the control group.ConclusionsRamosetron use led to a lower incidence, mild severity of nausea, and reduced use of rescue antiemetic drug after arthroscopic rotator cuff repair during the 6- to 24-h postoperative period than the control.Level of evidenceLevel I, randomized controlled trials, treatment study
Highlights
Rotator cuff disease is one of the common causes of shoulder pain and is commonly treated by arthroscopic rotator cuff repair, in which patients tend to experience intense postoperative pain [1, 2]
When patients with high risk of postoperative nausea and vomiting (PONV) are planned to be treated with opioid-based IV patient-controlled analgesia (PCA), appropriate prophylactic antiemetic treatment should be considered, rather than treating the established PONV
The number of nausea-free patients was greater in the ramosetron group than in the control group during the 6- to 24-h period (p = 0.007) (Table 2)
Summary
Rotator cuff disease is one of the common causes of shoulder pain and is commonly treated by arthroscopic rotator cuff repair, in which patients tend to experience intense postoperative pain [1, 2]. Among various antiemetic drugs tried, serotonin receptor antagonists such as ondansetron [15], granisetron [16], and dolasetron [17] are the most commonly used to prevent PONV. They have very short duration of action to cover the immediate postoperative period and have limited effect on postoperative vomiting rather than an anti-nausea action [9, 18, 19]. This study aimed to evaluate the effectiveness of ramosetron or ondansetron to relieve postoperative nausea and vomiting (PONV) and pain after arthroscopic rotator cuff repair
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
