Prophylaxis of postoperative nausea and vomiting: controversies in the use of serotonin 5-hydroxytryptamine subtype 3 receptor antagonists

Kovac, Anthony L.

doi:10.1016/j.jclinane.2005.06.012

Cited by 20 publications

(20 citation statements)

References 134 publications

(206 reference statements)

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“…and 24 mg p.o. in adults and 0.15 mg/kg in children for patients with liver disease [103]. The recommended dose of granisetron for CINV is 2 mg p.o.…”

Section: Therapeutic Usesmentioning

confidence: 99%

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Safety and efficacy of commonly used antiemetics

Hendren

Aponte-Feliciano

Kovac³

2015

Expert Opinion on Drug Metabolism & Toxicology

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The key to providing relief for patients suffering from nausea and vomiting is to consider multiple drugs to approach the nausea in a systematic way. Anesthesiologists identify patients who are at high risk of nausea and vomiting based on physical characteristics and surgical procedures. Oncologists treat nausea based on the prescribed chemotherapeutics regimen and known risk of emesis while palliative care physicians and others balance the etiology of the nausea while optimizing patients other co morbid conditions.

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“…and 24 mg p.o. in adults and 0.15 mg/kg in children for patients with liver disease [103]. The recommended dose of granisetron for CINV is 2 mg p.o.…”

Section: Therapeutic Usesmentioning

confidence: 99%

“…is the optimum dose administered immediately before start of anesthesia [17]. Vital sign changes following 5-HT 3 RA administration are minimal and not dose-related [17,90,103]. Palonosetron at 0.075 mg i.v.…”

Section: Therapeutic Usesmentioning

confidence: 99%

Safety and efficacy of commonly used antiemetics

Hendren

Aponte-Feliciano

Kovac³

2015

Expert Opinion on Drug Metabolism & Toxicology

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“…How the efficacy of different 5-HT3 receptor antagonists vary is still unclear but most probably these differences may involve multiple factors such as intrinsic differences in 5-HT3 receptor blocking activity, 5- HT3 receptor affinity and binding stability, and differences in autocrine activity of serotonin released from enterochromaffin cells to act on 5-HT3 or 5-HT4 receptors on EC cells. [41]…”

Section: Discussionmentioning

confidence: 99%

Palonosetron: A novel approach to control postoperative nausea and vomiting in day care surgery

Bajwa

Kaur

et al. 2011

Saudi J Anaesth

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Background:Postoperative nausea and vomiting (PONV) is one of the complications which hamper the successful implementation of day care surgical procedure in spite of the availability of so many antiemetic drugs and regimens for its prevention. The aim was to compare the prophylactic effects of intravenously (IV) administered ondansetron and palonosetron on PONV prevention in patients undergoing laparoscopic gynecological surgery under general anesthesia.Methods:A prospective double-blind study comprised of 60 ASAI/II female patients between the age group of 25 and 40 years was carried out in the Departments of Anesthesiology and Obstetrics and Gynecology of our institute. Patients were randomly divided into two groups of 30 patients each in a double-blind manner. Group I received 8 mg of inj. ondansetron IV while group II received inj. palonosetron 0.075 mg IV 5 minutes before the induction of anesthesia. The need for rescue antiemetics, episodes of PONV and other side effects were observed for 6 hours in the postanesthesia care unit and thereafter complaints were received on phone after the discharge. At the end of study, results were compiled and statistical data was subjected to statistical analysis using Student two-tailed ‘t’ and χ2 test and value of P<0.05 was considered significant.Results:The demographical profile of the patients was comparable. Twenty and 13.33% of the patients in group I had nausea and vomiting episodes postoperatively as compared to 6.67% and 3.33%, respectively, in group II which was statistically significant (P<0.05). Twenty percent of the patients in group I experienced significant post-op headache as compared to 6.67% in group II. The mean rescue dose of antiemetic was significantly higher (10.6 mg) in the group I as compared to group II (6.4 mg) (P=0.036). The rest of parameters were comparable and statistically nonsignificant.Conclusions:Palonosetron is a comparatively better drug to prevent the PONV in patients undergoing day care surgical procedures as compared to ondansetron as it has got a prolonged duration of action and favorable side-effects profile.

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“…No existe evidencia de diferencias en cuanto a eficacia o perfil de seguridad entre ellos, sin embargo el palonosetrón presenta la vida media más larga (40,41). En los últimos años varios trabajos han revisado la posible falta de eficacia de los antagonistas 5-HT3 en algunos pacientes en relación con factores farmacogenéticos (42)(43)(44).…”

Section: Antagonistas De Los Receptores De Serotonina (5-ht 3 )unclassified

Recomendaciones de prevención y tratamiento de las náuseas y vómitos postoperatorios y/o asociados a las infusiones de opioides

Gómez-Arnau

Aguilar

Bovaira

et al. 2010

Revista Española de Anestesiología y Reanimación

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Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Española de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating Este trabajo ha sido financiado mediante la concesión de una subvención de ProStrakan Farmacéutica SL a la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor.Aceptado para su publicación en agosto de 2010.Rev. Esp. Anestesiol. Reanim. 2010; 57: 508-524. Reproducido con permiso de REDAR.

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Prophylaxis of postoperative nausea and vomiting: controversies in the use of serotonin 5-hydroxytryptamine subtype 3 receptor antagonists

Cited by 20 publications

References 134 publications

Safety and efficacy of commonly used antiemetics

Safety and efficacy of commonly used antiemetics

Palonosetron: A novel approach to control postoperative nausea and vomiting in day care surgery

Recomendaciones de prevención y tratamiento de las náuseas y vómitos postoperatorios y/o asociados a las infusiones de opioides

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