The Korean Journal of Medicine

  • 제82권5호
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  • Pages.537-542
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  • 2012
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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수술 후 구역과 구토

Postoperative Nausea and Vomiting

  • 임현철 (연세대학교 의과대학 내과학교실)
  • Lim, Hyun-Chul (Department of Internal Medicine, Yonsei University College of Medicine)
  • 발행 : 2012.05.01
⟨ 이전 논문 다음 논문 ⟩

초록

Postoperative nausea and vomiting (PONV) is considered as a main cause of dissatisfaction after surgery with postoperative pain. Overall incidence of PONV is 30%, and the incidence rate can increase up to 70-80% in high-risk patient groups. The causes of PONV are multifactorial and can largely be categorized as patient risk factors, surgical procedure, and anaesthetic technique. Pharmacological treatments including dopamine antagonist, anti-histamines, anticholinergics, dexamethasone, neurokinin-1 antagonists, and serotonin antagonist are used to prevent and treat PONV. This article reviews the prevalence, mechanisms, and risk factors of PONV, and how to prevent and treat it.

키워드

참고문헌

  1. Franck M, Radtke FM, Apfel CC, et al. Documentation of postoperative nausea and vomiting in routine clinical practice. J Int Med Res 2010;38:1034-1041. https://doi.org/10.1177/147323001003800330
  2. Cohen MM, Duncan PG, DeBoer DP, Tweed WA. The postoperative interview: assessing risk factors for nausea and vomiting. Anesth Analg 1994;78:7-16.
  3. Clergue F, Auroy Y, Pequignot F, Jougla E, Lienhart A, Laxenaire MC. French survey of anesthesia in 1996. Anesthesiology 1996;91:1509-1520.
  4. Owings MF, Kozak LJ. Ambulatory and inpatient procedures in the United States, 1996. Vital Health Stat 1998;13:1-119.
  5. Cosow CE, Haspel KL, Smith SE, Grecu L, Bittner EA. Haloperidol versus ondansetron for prophylaxis of postoperative nausea and vomiting. Anesth Analg 2008;106:1407-1409. https://doi.org/10.1213/ane.0b013e3181609022
  6. Fujii Y, Itakura M. A prospective, randomized, doubleblind, placebo-controlled study to assess the antiemetic effects of midazolam on postoperative nausea and vomiting in women undergoing laparoscopic gynecologic surgery. Clin Ther 2005;32:1633-1637.
  7. Apfel CC, Laara E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology 1999;91:693-700. https://doi.org/10.1097/00000542-199909000-00022
  8. Kreis ME. Postoperative nausea and vomiting, Auton Neurosci 2006;30;129:86-91.
  9. White PF. Prevention of postoperative nausea and vomitinga multimodal solution to a persistent problem. N Engl J Med 2004;350:2511-2512. https://doi.org/10.1056/NEJMe048099
  10. Jung JS, Park JS, Kim SO, et al. Prophylactic antiemetic effect of midazolam after middle ear surgery. Otolaryngol Head Neck Surg 2007;137:753-756. https://doi.org/10.1016/j.otohns.2007.07.024
  11. Jensen K, Kehlet H, Lund CM. Post-operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime. Acta Anaesthesiol Scand 2007;51:464-471. https://doi.org/10.1111/j.1399-6576.2006.01251.x
  12. Scuderi PE, James RL, Harris L, Mims GR III. Multimodal antiemetic management prevents early postoperative vomiting after outpatient laparoscopy. Anesth Analg 2000;91:1408-1414. https://doi.org/10.1097/00000539-200012000-00020
  13. Joo HS, Perks WJ. Sevoflurane versus propofol for anesthetic induction: a meta-analysis. Anesth Analg 2000;91:213-219.
  14. Roberts GW, Bekker TB, Carlsen HH, Moffatt CH, Slattery PJ, McClure AF. Postoperative nausea and vomiting are strongly influenced by postoperative opioid use in a dose-related manner. Anesth Analg 2005;101:1343-1348. https://doi.org/10.1213/01.ANE.0000180204.64588.EC
  15. Shende D, Das K. Comparative effects of intravenous ketorolac and pethidine on perioperative analgesia and postoperative nausea and vomiting (PONV) for paediatric strabismus surgery. Acta Anaesthesiol Scand 1999;43:265-269. https://doi.org/10.1034/j.1399-6576.1999.430305.x
  16. Marret E, Kurdi O, Zufferey P, Bonnet F. Effects of nonsteroidal antiinflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials. Anesthesiology 2005;102:1249-1260. https://doi.org/10.1097/00000542-200506000-00027
  17. Fan CF, Tanhui E, Joshi S, Trivedi S, Hong Y, Shevde K. Acupressure treatment for prevention of postoperative nausea and vomiting. Anesth Analg 1997;84:821-825. https://doi.org/10.1213/00000539-199704000-00023
  18. Zarate E, Mingus M, White PF, et al. The use of transcutaneous acupoint electrical stimulation for preventing nausea and vomiting after laparoscopic surgery. Anesth Analg 2001;92:629-635. https://doi.org/10.1213/00000539-200103000-00014
  19. Carlisle JB, Stevenson CA. Drugs for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev 2006;CD004125.
  20. Wallenborn J, Gelbrich G, Bulst D, et al. Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone: randomised double blind multicentre trial. BMJ 2006;333:324-328. https://doi.org/10.1136/bmj.38903.419549.80
  21. White PF. Droperidol: a cost-effective antiemetic for over thirty years. Anesth Analg 2002;95:789-790.
  22. Napolitano C, Schwartz PJ, Brown AM, et al. Evidence for a cardiac ion channel mutation underlying drug induced QT prolongation and life threatening arrhythmias. J Cardiovasc Electrophysiol 2000;11:691-696. https://doi.org/10.1111/j.1540-8167.2000.tb00033.x
  23. Scuderi PE. Pharmacology of antiemetics. Int Anesthesiol Clin 2003;41:41. https://doi.org/10.1097/00004311-200341040-00006
  24. Apfel CC, Zhang K, George E, et al. Transdermal scopolamine for the prevention of postoperative nausea and vomiting: a systematic review and meta-analysis. Clin Ther 2010;32:1987-2002. https://doi.org/10.1016/j.clinthera.2010.11.014
  25. Apfel CC, Korttila K, Abdalla M, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med 2004;350:2441-2451. https://doi.org/10.1056/NEJMoa032196
  26. Gyermek L. 5-HT3 receptors: pharmacologic and therapeutic aspects. J Clin Pharmacol 1995;35:845-855. https://doi.org/10.1002/j.1552-4604.1995.tb04129.x
  27. Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology 1992;77:162-184. https://doi.org/10.1097/00000542-199207000-00023
  28. Kovac AL, Eberhart L, Kotarski J, et al. A randomized, double-blind study to evaluate the efficacy and safety of three different doses of palonosetron versus placebo in preventing postoperative nausea and vomiting over a 72-hour period. Anesth Analg 2008;107:439-444. https://doi.org/10.1213/ane.0b013e31817abcd3
  29. Diemunsch P, Gan TJ, Philip BK, et al. Single-dose aprepitant vs ondansetron for the prevention of postoperative nausea and vomiting: a randomized, double-blind phase III trial in patients undergoing open abdominal surgery. Br J Anaesth 2007;99:202-211. https://doi.org/10.1093/bja/aem133

피인용 문헌

  1. Review article: the evolution of endpoint assessments for chemotherapy‐induced nausea and vomiting and post‐operative nausea and vomiting—a perspective from the US Food and Drug Admi vol.54, pp.1, 2012, https://doi.org/10.1111/apt.16386