Sung Y F
Department of Anaesthesiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Drug Saf. 1996 Mar;14(3):181-97. doi: 10.2165/00002018-199614030-00005.
Postoperative nausea and vomiting (PONV) is an age-old problem; more so since the blooming of ambulatory or day surgery centres within the last 2 decades. The aetiology of PONV is multifactorial. The incidence of PONV is usually higher in women and children than in men. PONV not only causes patient discomfort, anxiety in mild cases, and serious complications in severe cases, it also decreases cost efficiency. The benefits and risks of old and new antiemetic drugs used worldwide to treat PONV are discussed in this article, including the newly developed serotonin 5-hydroxytryptamine 3 (5HT3) antagonists. All the medications currently used to treat PONV have both advantages and disadvantages. If used indiscriminately to treat patients who have no problems with PONV, the risks of adverse effects often outweigh the benefits. The patient's history and the nature of the surgery are good indicators for defining those at risk from PONV; for patients at risk preventive treatment is essential. However, it is almost impossible to pick one agent or one combination as the therapy of choice using the present available data. A patient history of a favourable response to a previously used antiemetic would make that drug the agent of choice. So far, the newcomers, the 5HT3 antagonists, have fewer reported adverse effects.
术后恶心呕吐（PONV）是一个由来已久的问题；自过去20年内门诊或日间手术中心蓬勃发展以来，这一问题愈发突出。PONV的病因是多因素的。PONV的发生率在女性和儿童中通常高于男性。PONV不仅会导致患者不适，轻度病例会引起焦虑，重度病例会引发严重并发症，还会降低成本效益。本文讨论了全球范围内用于治疗PONV的新旧止吐药物的益处和风险，包括新开发的5-羟色胺3（5HT3）拮抗剂。目前所有用于治疗PONV的药物都有其优缺点。如果不加区分地用于治疗没有PONV问题的患者，不良反应的风险往往大于益处。患者的病史和手术性质是确定PONV风险人群的良好指标；对于有风险的患者，预防性治疗至关重要。然而，根据目前可用的数据，几乎不可能选择一种药物或一种联合用药作为首选治疗方法。患者对先前使用的止吐药有良好反应的病史会使该药物成为首选药物。到目前为止，新出现的5HT3拮抗剂报告的不良反应较少。
