Discussion
nausea, postoperative pain, drowsiness, dizziness, headache, PONV, nausea 1
ADVERSE EVENTS, ADVERSE EFFECTS
This is the first randomized, double-blind study to investigate the effect of ramosetron and dexamethasone on the prevention of PONV in patients at low risk of developing PONV after surgery under general anesthesia. Compared with group C, group DR showed a lower incidence of PONV and a reduction in the use of rescue antiemetics and rescue analgesics for 48 h postoperatively in low-risk patients undergoing surgery under general anesthesia. Moreover, compared with group C, group R showed a lower incidence of PONV and a reduction in the use of rescue antiemetics and rescue analgesics 0–1 h postoperatively.Selective serotonin 5-HT3 receptor antagonists, such as ramosetron, have a well-established role in the prophylaxis and treatment of PONV owing to their efficacy and fewer side effects compared with other antiemetics [Previous studies focused on the prevention of PONV in high-risk groups; however, this study focused on a low-risk group and showed that the incidence of nausea and need for rescue antiemetics 0–1 h postoperatively was significantly lower in groups DR and R than in group C. In addition, the incidence of nausea and need for rescue antiemetics were significantly lower in group DR than in group C 48 h postoperatively. However, the incidence of nausea and the need for rescue antiemetics did not differ significantly between groups DR and R. The incidence of PONV after laparoscopic surgery in high-risk patients ranges from 40 to 80% [In this study, patients underwent surgeries under general anesthesia with sevoflurane and had a low risk of developing PONV (Apfel score, 1.2 ± 0.7). The incidence of nausea 1 and 48 h postoperatively was 9% and 16%, respectively, when 0.3 mg of ramosetron was administered at the end of the surgery, and the need for rescue antiemetics 1 and 48 h postoperatively was 7% and 12%, respectively. Yoo et al. reported the administration of 0.3 mg of ramosetron to patients at low risk of developing PONV (Apfel score, 1.7 ± 0.5) who underwent laparoscopic radical prostatectomy and general anesthesia with desflurane [Single-dose dexamethasone is effective for the management of postoperative pain after various surgeries, including laparoscopic surgery [We monitored the patients for major adverse effects related to the administration of ramosetron and dexamethasone, such as headache, dizziness, and drowsiness, for 48 h postoperatively. Both drugs were tolerated well during the study period, and the addition of dexamethasone to ramosetron did not influence the incidence of adverse events. The incidence of these adverse effects (8%) was lower than that of PONV (17%). The incidence of side effects, such as headache, dizziness, and drowsiness, was lower than that reported in previous studies (25–39%) [This study has a limitation. Our study included patients who had undergone several types of surgery. However, only patients with relatively short surgical times were studied to minimize the confounding effects of surgery.