RETRACTED ARTICLE: Management of postoperative nausea and vomiting in women scheduled for breast cancer surgery

Abstract

Breast cancer surgery performed under general anesthesia is associated with a high incidence of postoperative nausea and vomiting (PONV). A number of approaches are available for the management of PONV after breast cancer surgery. First, the risk factors related to patient characteristics, surgical procedure, anesthetic technique, and postoperative care can be reduced. More specifically, the use of propofol-based anesthesia can reduce the incidence of PONV. Secondly, a wide range of prophylactic antiemetics, including butyrophenones (droperidol), benzamides (metoclopramide), glucocorticoids (dexamethasone), clonidine, a small dose of propofol, and serotonin receptor (SR) antagonists (ondansetron, granisetron, tropisetron, dolasetron, ramosetron, and palonosetron), are available for preventing PONV. Thirdly, antiemetic therapy combined with granisetron and droperidol or dexamethasone, and a multimodal management strategy which includes a package consisting of dexamethasone, total intravenous anesthesia with propofol, and ondansetron are highly effective in preventing PONV. Unfortunately, the use of glucocorticoids and SR antagonists for preventing PONV is not permitted in Japan according to national health insurance guidelines. Fourth, electro-acupoint stimulation at the P6 point (Nei-Guwan) as a non-pharmacologic therapy is as effective as ondansetron for preventing PONV. Knowledge of the risk factors for PONV, antiemetics, and a non-pharmacologic approach are needed for the management of PONV in women undergoing breast cancer surgery.

Salidroside Attenuates Concanavalin A-Induced Hepatitis via Modulating Cytokines Secretion and Lymphocyte Migration in Mice

“…Among these effector cells, CD4 + T lymphocytes and cytotoxic CD8 + T lymphocytes (CTL) are the predominant cells infiltrated into the liver [12]. In our study, we found that the number of CD4 + and CD8 + T lymphocytes located in the liver was increased dramatically after Con A injection.…”

“…Salidroside exhibits its function partly through modulating the activity of NF- κ B [12], which is a nuclear transcription factor regulating the expression of genes involved in inflammation. Our results indicated salidroside pretreatment suppressed I κ B α kinase and p65 phosphorylation in Con A-induced hepatitis, which in turn inhibited the activation of NF- κ B.…”

“…Several experimental and clinical studies of salidroside have provided evidence for its pharmacological activities, including anti-inflammation [7], antioxidation [8], antistress, antihypoxia, anticancer, and enhancing immune effects [9–11]. One recent study demonstrated that salidroside was an effective suppressor of inflammation by focusing on the prophylaxis effect of mastitis [12]. …”

Effects of pretreatment with intravenous palonosetron for propofol-remifentanil-based anesthesia in breast and thyroid cancer surgery: a double-blind, randomized, controlled study

“…The incidence of PONV is known to be influenced by patient characteristics, type of surgical procedure, anesthesia technique, and postoperative analgesics [3]. Generally, female gender, a history of motion sickness, previous PONV, and nonsmoking are risk factors associated with PONV [3], and we had no differences in these risk factors between the two groups in the present study. Kim et al [4] reported that the incidence of PONV during the first 24 h after endoscopic thyroidectomy was 14.6% in a TIVA group compared to 51% in a balanced anesthesia group.…”

“…The first step for the prevention of PONV is to reduce risk factors, i.e., by the use of propofol-based anesthesia and decreased use of intraoperative N 2 O and postoperative opioids. Secondly, prophylactic antiemetics are available [3]. Some studies have indicated that total intravenous anesthesia using propofol and remifentanil might alleviate PONV during the early postoperative period (< 24 h) compared to volatile anesthesia [4].…”