• Won Joong Kim, Hyun Kang, Hwa Yong Shin, Chong Wha Baek, Yong Hun Jung, Young Cheol Woo, Jin Yun Kim, and Gil Hoi Koo.
• Department of Anaesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
• J. Int. Med. Res. 2013 Aug 1;41(4):1203-13.

ObjectiveTo compare the efficacy of ramosetron, midazolam, and the combination of ramosetron and midazolam in the prevention of postoperative nausea and vomiting (PONV) in female patients undergoing thyroidectomy.MethodsPatients were randomized to receive 0.3 mg ramosetron (Group R), 75 µg/kg midazolam (Group M) or 0.3 mg ramosetron combined with 75 µg/kg midazolam (Group RM) before the induction of anaesthesia. PONV, use of rescue antiemetics, pain severity and fentanyl consumption were assessed for 24 h after thyroidectomy.ResultsA total of 100 patients were enrolled; 94 patients completed the study. The severity of nausea was statistically significantly reduced at 0-2 h in Group RM compared with Groups R and M, and at 2-6 h in Group RM compared with Group M. The incidence of retching and vomiting was significantly lower at 0-2 h, 2-6 h, 6-12 h in Group RM than in Group M, and lower in Group R than Group M at 6-12 h. The requirement for rescue antiemetics was significantly lower at 0-2 h in group RM than in group M.ConclusionThe combination therapy of ramosetron and midazolam provided superior antiemetic efficacy compared with midazolam single therapy, but did not show any significant additional benefits compared with ramosetron single therapy.

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