ID 83819
Title Transcription
ジュツゴ ノ オウキ オウト : センタクテキ ニューロキニン 1 ジュヨウタイ キッコウヤク ガ オヨボス エイキョウ
Title Alternative
Post-operative nausea and vomiting : the effect of Neurokinin‐1receptor antagonism
Author
Kadota, Takako Center for Post-graduate Medical Education Hospital, Tokushima University Hospital
Tsutsumi, Yasuo M Department of Anesthesiology, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Oshita, Syuzo Department of Anesthesiology, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Tanaka, Katsuya Department of Anesthesiology, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Keywords
post-operative nausea and vomiting
Neurokinin-1receptor antagonism
aprepitant
Content Type
Journal Article
Description
Post-operative nausea and vomiting(PONV)remains the most frequently reported patients complaint after anesthesia, and for patients, it is of greater concern than postoperative pain. PONV has four main risk factors including : female gender, history of PONV or motion sickness, nonsmoking, and the use of postoperative opioids. Primary control of nausea and vomiting arises from the central pattern generator for vomiting located in the medulla oblongara.
Traditionally, the most common anti-emetics used to treat PONV include serotonin 5-hydroxytryptamine type3antagonists such as ondansetron, corticosteroids, like dexamethasone, or droperidol, which is a neuroleptic. However, these anti-emetics are not completely reliable and only reduce the incidence of PONV by~26%. Adding additional anti-emetics could further lower the incidence of PONV.
PONV can result in several post-surgical complications. Neurokinin-1(NK-1)receptors are found in gastrointenstinal vagal afferents and within the central nervous system vomiting reflex pathways. NK-1receptors are activated by Substance P, which is a regulatory peptide and preferred endogenous ligand.
We investigated whether NK-1antagonism can effectively diminish PONV in patients undergoing laparoscopic gynecological surgery. Forty two patients were randomized into two groups : NK-1 group which received an oral NK-1antagonist, aprepitant at80mg, and a control that did not receive any anti-emetic. PONV incidence at2hours was present in both control and NK-1groups and was 81% and52%, respectively. At24hours PONV was present in the control group, but was absent in the NK1group(27% and0%,respectively).
PONV is associated with dissatisfaction after anesthesia and surgery, can result in several postsurgical complications. NK-1receptor antagonism effectively lowered PONV, and expedited recovery in patients undergoing laparoscopic gynecological surgery.
Journal Title
四国医学雑誌
ISSN
00373699
NCID
AN00102041
Volume
67
Issue
3-4
Start Page
143
End Page
146
Sort Key
143
Published Date
2011-08-25
Remark
EDB ID
FullText File
language
jpn
departments
Medical Sciences