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ID 83819
タイトルヨミ
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
タイトル別表記
Post-operative nausea and vomiting : the effect of Neurokinin‐1receptor antagonism
著者
門田, 尚子 徳島大学病院卒後臨床研修センター
堤, 保夫 徳島大学大学院ヘルスバイオサイエンス研究部病態情報医学講座麻酔・疼痛治療医学分野 KAKEN研究者をさがす
大下, 修造 徳島大学大学院ヘルスバイオサイエンス研究部病態情報医学講座麻酔・疼痛治療医学分野 徳島大学 教育研究者総覧 KAKEN研究者をさがす
田中, 克哉 徳島大学大学院ヘルスバイオサイエンス研究部病態情報医学講座麻酔・疼痛治療医学分野 徳島大学 教育研究者総覧 KAKEN研究者をさがす
キーワード
post-operative nausea and vomiting
Neurokinin-1receptor antagonism
aprepitant
資料タイプ
学術雑誌論文
抄録
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.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
67
3-4
開始ページ
143
終了ページ
146
並び順
143
発行日
2011-08-25
備考
EDB ID
フルテキストファイル
言語
jpn
部局
医学系