Wilkens Eric P, Yates Bill J
*Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, Iowa; and †Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Anesth Analg. 2005 Oct;101(4):1029-1033. doi: 10.1213/01.ane.0000166954.61498.2c.
Postoperative nausea and vomiting are significant problems. A method for measuring vomiting thresholds for anesthetics using plasma markers, such as arginine vasopressin (AVP), would be useful. We measured the change in AVP concentrations associated with morphine alone or in combination with ondansetron pretreatment. Data were collected from ferrets implanted with IV catheters. After recovery, the ferrets were administered IV morphine alone or with ondansetron pretreatment. Baseline blood samples were taken before morphine injection, and at 5, 10, 15, 30, 45, 60, and 90 min after morphine injection. Plasma AVP levels were measured using radioimmunoassay. Morphine alone was associated with a significant increase in plasma AVP concentrations from baseline at 45, 60, and 90 min (P < 0.05). Ondansetron alone did not change the plasma AVP concentration after 20 min (P > 0.46). There was no significant increase (P > 0.46) in AVP concentration in animals that were pretreated with ondansetron before administration of morphine. Two-way analysis of variance confirmed that ondansetron significantly decreased the increase in AVP by morphine at 60 and 90 min (P < 0.05). These data suggest that plasma AVP concentration may be an accurate marker for nausea, and may be useful to guide treatment for this condition.
The antiemetic, ondansetron, has an effect not only on clinically perceived vomiting, but also on plasma vasopressin level.
术后恶心和呕吐是严重问题。一种使用血浆标志物（如精氨酸加压素，AVP）来测量麻醉药呕吐阈值的方法会很有用。我们测量了单独使用吗啡或联合昂丹司琼预处理时AVP浓度的变化。数据收集自植入静脉导管的雪貂。恢复后，给雪貂单独静脉注射吗啡或进行昂丹司琼预处理后再注射吗啡。在注射吗啡前以及注射吗啡后5、10、15、30、45、60和90分钟采集基线血样。使用放射免疫分析法测量血浆AVP水平。单独使用吗啡时，在45、60和90分钟时血浆AVP浓度较基线显著升高（P < 0.05）。单独使用昂丹司琼在20分钟后未改变血浆AVP浓度（P > 0.46）。在注射吗啡前用昂丹司琼预处理的动物中，AVP浓度没有显著升高（P > 0.46）。双向方差分析证实，昂丹司琼在60和90分钟时显著降低了吗啡引起的AVP升高（P < 0.05）。这些数据表明血浆AVP浓度可能是恶心的准确标志物，可能有助于指导这种情况的治疗。
止吐药昂丹司琼不仅对临床上可感知的呕吐有作用，而且对血浆血管加压素水平也有影响。
