Pota Vincenzo, Coletta Francesco, Pascazio Francesca, Rinaldi Pasquale, Tomasello Antonio, De Marco Giovanna Paola, Schettino Francesca, Passavanti Maria Beatrice, Sansone Pasquale, Pace Maria Caterina, Barbarisi Manlio, Altieri Roberto, Villani Romolo, Coppolino Francesco
Department of Women, Child, General and Specialistic Surgery, University of Campania «L. Vanvitelli», 80138 Naples, Italy.
Emergency Anesthesia, Burn Intensive Care Unit and Poison Control Center, AORN Antonio Cardarelli, 80131 Naples, Italy.
Brain Sci. 2025 May 29;15(6):586. doi: 10.3390/brainsci15060586.
Neuroendoscopy is a minimally invasive surgical technique used to treat brain pathologies such as hydrocephalus, arachnoid cysts, and skull base tumors. While it offers several advantages, including reduced tissue trauma and lower morbidity, it is associated with a high risk of postoperative nausea and vomiting (PONV). This paper provides a narrative review of the literature on the incidence, pathophysiology, and management of PONV in patients undergoing neuroendoscopic procedures. The review includes several studies published between 2001 and 2024, analyzing specific risk factors such as female gender, postoperative opioid use, extended endoscopic approaches, and cavernous sinus dissection. PONV prevention strategies include a multimodal approach combining total intravenous anesthesia (TIVA) with propofol, perioperative hydration, and pharmacological prophylaxis (5-HT3 receptor antagonists, NK1 antagonists, dexamethasone, and droperidol). Despite advances in surgical and anesthetic techniques, further research is needed to develop procedure-specific protocols and optimize PONV management in neuroendoscopy.
神经内镜检查是一种用于治疗脑积水、蛛网膜囊肿和颅底肿瘤等脑部疾病的微创手术技术。虽然它具有多种优势，包括减少组织创伤和降低发病率，但它与术后恶心和呕吐（PONV）的高风险相关。本文对接受神经内镜手术患者PONV的发生率、病理生理学和管理方面的文献进行了叙述性综述。该综述包括2001年至2024年间发表的几项研究，分析了女性性别、术后使用阿片类药物、延长内镜手术入路和海绵窦解剖等特定风险因素。PONV预防策略包括多模式方法，将全静脉麻醉（TIVA）与丙泊酚、围手术期补液和药物预防（5-羟色胺3受体拮抗剂、神经激肽1拮抗剂、地塞米松和氟哌利多）相结合。尽管手术和麻醉技术取得了进展，但仍需要进一步研究来制定针对特定手术的方案，并优化神经内镜检查中PONV的管理。
