Continuous administration of ramosetron with patient-controlled analgesia after laparoscopic distal gastrectomy does not delay postoperative bowel function recovery: A prospective, randomized, double-blinded study

Hong Soo Jung, Jaewon Huh, Youngchan Kim, Sang Hyun Hong, Jaemin Lee

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Currently, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists are indicated to slow gastrointestinal motility in the diarrhea-predominant subtype of irritable bowel syndrome. They are commonly used to prevent or treat postoperative nausea and vomiting (PONV) and opioid-induced nausea and vomiting (OINV). We conducted a prospective, randomized, double-blinded study to investigate whether the continuous administration of ramosetron, a selective 5-HT3 receptor antagonist, for preventing PONV and/or OINV after laparoscopic distal gastrectomy (LDG) might influence bowel function recovery. Methods: Patients scheduled to undergo LDG were randomly assigned to 1 of 3 treatment regimens: no prophylactic ramosetron (Group C); ramosetron 0.6 mg added to 2-day intravenous patient-controlled analgesia (IV-PCA) (Group R0.6); and ramosetron 1.2 mg added to 2-day IV-PCA (Group R1.2). Postoperative recovery profiles of bowel function, incidence of postoperative nausea/ vomiting and pain, and perioperative data that affected bowel function recovery were evaluated. Results: Seventy-three patients completed the study protocol. Parameters associated with postoperative recovery of bowel function, such as time to first flatus, time to first bowel movement, time to first defecation, and time to commencement of soft diet, were not significantly different between the 3 groups. The incidence of nausea 2 to 24 hours after surgery was significantly lower in Group R0.6 (20.0%) and Group R1.2 (12.5%) than in Group C (45.8%) (P < .022). The ratio of complete response 2 to 24 hours after surgery was significantly higher in Group R0.6 (80.0%) and Group R1.2 (87.5%) than in Group C (54.2%) (P < .022). The incidence of retching 24 to 48 hours after surgery was significantly lower in Group R0.6 (0.0%) and Group R1.2 (4.2%) than in Group C (16.7%) (P < .043). Conclusion: Continuous administration of ramosetron with patient-controlled analgesia to prevent PONV and OINV after LDG did not delay postoperative bowel function recovery.

Original languageEnglish
Article numbere11503
JournalMedicine (United States)
Volume97
Issue number31
DOIs
StatePublished - 1 Aug 2018

Bibliographical note

Funding Information:
This study was funded entirely by the Department of Anesthesiology and Pain Medicine at Seoul St. Mary’s Hospital. No competing interests are declared.

Funding Information:
Funding/support: This study was funded entirely by the Department of Anesthesiology and Pain Medicine at Seoul St. Mary’s Hospital. No competing interests are declared.

Publisher Copyright:
Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.

Keywords

  • 5-hydroxytryptamine type 3
  • Irritable bowel syndrome
  • Opioid-induced nausea and vomiting
  • Postoperative bowel function recovery
  • Postoperative nausea
  • Vomiting

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