In this randomized, double-blinded study, we evaluated the efficacy of ramosetron and ondansetron for preventing postoperative nausea and vomiting (PONV) after middle ear surgery.

Seventy patients of either sex, ASA 1-2, scheduled middle ear surgery (mastoidectomy and tympanoplasty) under general anesthesia with sevoflurane and remifentanil were included. Patients were randomly divided into two groups and received IV ramosetron 0.3 mg (group R) or ondansetron 4 mg (group O) before the end of operation (n = 35 each). The incidence and severity of PONV, pain score (VAS), rescue antiemetic, rescue analgesic and side effects were assessed following 6 hr, 24 hr and 48 hr after surgery.

The incidence of PONV showed no significant difference between groups at each time points after surgery. There were no difference in the severity of nausea, pain score, rescue antiemetic, analgesic drug usage and side effects between groups.

Prophylactic therapy with ramosetron is as effective and safe as conventional prophylactic therapy with ondansetron for preventing PONV in patients undergoing general anesthesia for middle ear surgery.