A meta-analysis of randomized controlled trials illustrated that the serotonin receptor antagonist ramosetron lowered postsurgery pain score, decreased chances of postoperative nausea and vomiting (PONV) and postoperative vomiting, minimized rescue antiemetics usage, and did not elevate chances of discontinuing patient-controlled analgesia (PCA) when compared to ondansetron or palonosetron after spinal surgery in adult patients.

Researchers sought to determine ramosetron's effectiveness and tolerance for PONV prevention following spinal surgery. Databases like Cochrane Library, Medline, Science Citation Index, and Embase were systematically searched to find out suitable trials that compared ramosetron use with other serotonin antagonists for PONV treatment after spinal surgery. Study selection, quality evaluation, and extraction of data were done by 2 reviewers.

Overall, 88 potentially relevant articles were recognized. Only 3 fulfilled the selection criteria. In all the 3 articles, the study drugs were given at the end of spinal surgery. Ramosetron (0.3 mg) was found to lower pain score (mean difference = −0.66), minimize PONV risk (risk ratio = 0.86), and postsurgery vomiting (risk ratio = 0.32), and restricted the use of rescue antiemetics (risk ratio = 0.66) following spinal surgery.

Regarding occurrence of postsurgery nausea, usage of rescue pain medicines, number of rescue analgesic agents needed, and chances of PCA discontinuity between ramosetron and ondansetron (4 mg) or palonosetron (0.075 mg), no profound differences were noted. No considerable differences were noted in the risk of side effects among the three medicines. Thus, ramosetron use is beneficial for PONV prevention after spinal surgery.