Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Perth, Western Australia;
Ther Clin Risk Manag. 2009 Feb;5(1):21-34. Epub 2009 Mar 26.
Postoperative nausea and vomiting (PONV) remains a significant problem in modern anesthetic practice, with an incidence in high-risk groups of up to 80%. In addition to being unpleasant and distressing for the patient, PONV has the potential to adversely affect patient and surgical outcomes. Advances in PONV prophylaxis over recent years include using non-pharmacological means to reduce baseline risk, a change to less emetogenic anesthetic techniques and the combination of multiple antiemetic drugs. The 5-hydroxytryptamine-3 (5-HT(3)) antagonists have proven a particularly valuable addition to the armamentarium against PONV. Palonosetron is a second-generation 5-HT(3) antagonist that has recently been approved for prophylaxis against PONV. It has unique structural, pharmacological and clinical properties that distinguish it from other agents in its class. This review summarizes current evidence on PONV prophylaxis, reviews the 5-HT(3) antagonists in particular and focuses on the established and future roles of palonosetron.
术后恶心和呕吐（PONV）仍然是现代麻醉实践中的一个重大问题，高危人群的发生率高达 80%。PONV 不仅使患者感到不适和痛苦，还有可能对患者和手术结果产生不利影响。近年来，PONV 预防方面的进展包括使用非药物手段降低基线风险、改变致吐性较低的麻醉技术以及联合使用多种止吐药物。5-羟色胺 3（5-HT3）拮抗剂已被证明是防治 PONV 的一种特别有价值的手段。帕洛诺司琼是一种第二代 5-HT3 拮抗剂，最近已获准用于预防 PONV。它具有独特的结构、药理学和临床特性，使其与同类药物区分开来。这篇综述总结了目前关于 PONV 预防的证据，特别回顾了 5-HT3 拮抗剂，并重点介绍了帕洛诺司琼的现有和未来作用。
