Department of Pharmaceutical, Social, and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama 35229, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 May;115(5):601-11. doi: 10.1016/j.oooo.2012.09.088. Epub 2013 Jan 10.
Patients have rated severe nausea to be worse than postoperative pain. The overall incidence of postoperative nausea and vomiting (PONV) is 25%-30% and can lead to delayed discharge and unanticipated hospital admission. After outpatient surgery, the overall incidence of postdischarge nausea has been reported to be 17% and of vomiting 8%, higher than nausea and vomiting reported during the procedure or recovery. Patients who experienced postdischarge nausea and vomiting (PDNV) were unable to resume normal daily activities as quickly. This paper addresses the frequency, pathophysiology and patient perception of PONV and PDNV and reviews antiemetics and adjunctive medications used for the prevention, management, and treatment of PONV and PDNV. For each, the indication, mechanism of action, adverse effects, drug interactions, and implications for oral surgery and outpatient sedation are provided. Because many antiemetics are available for prevention, management, and treatment of PONV and PDNV, optimal medication choices are important for each procedure and patient.
患者认为严重恶心比术后疼痛更严重。术后恶心和呕吐（PONV）的总发生率为 25%-30%，可导致出院后延迟和意外住院。在门诊手术后，已报告出院后恶心的总发生率为 17%，呕吐发生率为 8%，高于手术过程中和恢复期报告的恶心和呕吐发生率。经历过出院后恶心和呕吐（PDNV）的患者无法像往常一样快速恢复正常活动。本文讨论了 PONV 和 PDNV 的频率、病理生理学和患者感知，并回顾了用于预防、管理和治疗 PONV 和 PDNV 的止吐药和辅助药物。对于每一种药物，都提供了适应证、作用机制、不良反应、药物相互作用以及对口腔手术和门诊镇静的影响。由于有许多止吐药可用于预防、管理和治疗 PONV 和 PDNV，因此针对每个手术和患者，选择最佳药物非常重要。
