This study was designed to evaluate ramosetron oral disintegrating tablet (ODT), a 5-HT₃ receptor antagonist, for prophylaxis and treatment of postoperative nausea and vomiting (PONV) in patients undergoing general anesthesia using patient controlled analgesia (PCA).

150 adult, ASA physical status I or II, aged 18-65 yr, patients undergoing elective surgery were enrolled (n = 50 in each). Patients were randomly assigned to one of three groups, group C (no prophylactic antiemetics), groups N (ramosetron ODT 30 minutes before the induction), and group Z (intravenous injection of ondansetron 4 mg at the end of surgery followed by continuous infusion of 8 mg added to the PCA solution). A standard general inhalation anesthesia and IV PCA with fentanyl and ketorolac were used. During the 48 hours after recovery, we assessed pain score by: using a visual analogue scale (VAS), a sedation scale, an incidence of PONV, and monitoring consumption of PCA drug, rescue drug consumption, adverse events, and overall satisfaction.

The incidence of nausea and the consumption of rescue drug were significantly decreased in N and Z groups at each time point except 24-48 hours after recovery. There was no significant difference in incidence of vomiting. Overall satisfaction was superior in N and Z groups compared with C group.

Preoperative administration of ramosetron ODT was an acceptable and effective way to prevent PONV in patients using PCA.