Comparison between Ramosetron and Palonosetron in Patients Receiving Opioid-Based Intravenous Patient-Controlled Analgesia after Thyroidectomy: A Propensity Score Matching Analysis

Background: Ramosetron and palonosetron are new potent 5-hydroxytryptamine 3 antagonists. This study compared the effects of ramosetron and palonosetron in preventing postoperative nausea and vomiting (PONV) in patients receiving opioid-based intravenous (IV) patient-controlled analgesia (PCA) after thyroidectomy. Materials and Methods: We reviewed the electronic medical records of 1056 adults who received fentanyl-based IV PCA after thyroidectomy at Chung-Ang University Hospital between January 1, 2010, and December 31, 2016. After excluding 152 patients who did not match the inclusion criteria, we classified patients into two groups based on their single use of prophylactic anti-emetics: ramosetron (Group R, n= 304) and palonosetron (Group R, n= 600). Propensity scoring matching was then applied to match patients from each group in a 1: 1 ratio. Results: The comparison groups generated by propensity scores were well balanced with respect to all of the collected baseline risk factors. Before propensity score analysis, the nausea visual analog scale score was lower in Group R than in Group P on day 0 and day 1, and rescue anti-emetics requirements were lower in Group R than in Group P on day 0. However, after propensity score matching, there was no difference between the two groups. Conclusions: There was no difference in the efficacy of ramosetron and palonosetron in patients receiving opioid-based IV PCA after thyroidectomy.