Prevention of nausea and vomiting after middle ear surgery: granisetron versus ramosetron

Middle ear surgery is associated with a relatively high incidence of postoperative nausea and vomiting. This study was undertaken to compare the efficacy of ramosetron with granisetron for preventing nausea and vomiting after middle ear surgery.

Prospective, randomized, double-blind study.

In a randomized, double-blind manner, 100 ASA I patients (69 women), aged 23 to 65 years, received either ramosetron 0.3 mg or granisetron 3 mg intravenously (n = 50 of each) immediately before the induction of anesthesia. A standard general anesthetic technique and postoperative analgesia were used. Postoperative nausea and vomiting and safety assessments were performed continuously during the first 24 hours (0-24 h) and the next 24 hours (24-48 h) after anesthesia.

A complete response, defined as no nausea and vomiting and no need for another rescue medication, during the first 24 hours after anesthesia (0-24 h) occurred in 90% of patients receiving ramosetron and in 86% of patients receiving granisetron, respectively (P = .379); the corresponding incidence rates in the second 24 hours after anesthesia (24-48 h) were 90% and 66% (P = .003). No clinically important adverse events were observed in either group.

Prophylactic use of ramosetron is more effective than granisetron for long-term prevention of nausea and vomiting after middle ear surgery.