scholarly journals Prevention of Postoperative Nausea and Vomiting in Elective Hysterectomy: A Prospective, Randomized, Placebo Controlled Outcomes Trial of Aprepitant NK-1-Receptor Antagonist

2014 ◽  
Vol 04 (12) ◽  
pp. 301-307 ◽  
Author(s):  
Jaime B. Long ◽  
Luisa Galdi ◽  
Joseph G. Hentz ◽  
John B. Leslie ◽  
Paul M. Magtibay ◽  
...  
Keyword(s):  
Receptor Antagonist ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting

scholarly journals Involvement of leukotriene pathway in the development of sevoflurane-induced pica in rats

2019 ◽  
Vol 97 (5) ◽  
pp. 436-439
Author(s):  
Kouichi Yamamoto ◽  
Atsushi Yamatodani
Keyword(s):  
Receptor Antagonist ◽  
Mrna Expression ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Phospholipase A ◽  
Nausea And Vomiting ◽  
Leukotriene Receptor Antagonist ◽  
Leukotriene Receptor

We previously reported that sevoflurane-induced pica, kaolin ingestion behavior, in rats has the potential to reflect postoperative nausea and vomiting (PONV) in humans. It is well-known that corticosteroids, which inhibit both prostaglandin and leukotriene syntheses due to phospholipase A2 inhibition, are effective for reducing PONV; however, the precise mechanisms remain unclear. We investigated the involvement of the prostaglandin or leukotriene pathway in the development of sevoflurane-induced pica. We found that sevoflurane-induced pica was effectively inhibited by pretreatment with a leukotriene receptor antagonist (montelukast) or an inhibitor of 5-lipoxygenase (zileuton), rather than an inhibitor of cyclooxygenase (flurbiprofen). Furthermore, we observed that sevoflurane significantly increased urinary leukotriene excretion and 5-lipoxygenase mRNA expression in the spleen, but not hypothalamus. These results suggest that the production of leukotriene may lead to the development of sevoflurane-induced pica in rats, and that inhibition of the leukotriene pathway could be potentially useful for the treatment of PONV.

scholarly journals A Comparison of Fosaprepitant and Ondansetron for Preventing Postoperative Nausea and Vomiting in Moderate to High Risk Patients: A Retrospective Database Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Chiaki Murakami ◽  
Nami Kakuta ◽  
Katsuyoshi Kume ◽  
Yoko Sakai ◽  
Asuka Kasai ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Receptor Antagonist ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Nausea And Vomiting ◽  
Nk1 Receptor Antagonist ◽  
Risk Patients ◽  
Neurokinin 1 ◽  
Type 3

Postoperative nausea and vomiting (PONV) occur in 30–50% of patients undergoing general anesthesia and in 70–80% of high PONV risk patients. In this study, we investigated the efficacy of fosaprepitant, a neurokinin-1 (NK1) receptor antagonist, compared to ondansetron, a selective 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist, in moderate to high PONV risk patients from our previous randomized controlled trials. Patients (171 patients from 4 pooled studies) with the Apfel simplified score ≥ 2 and undergoing general anesthesia were randomly allocated to receive intravenous fosaprepitant 150 mg (NK1 group, n=82) and intravenous ondansetron 4 mg (ONS group, n=89) before induction of anesthesia. Incidence of vomiting was significantly lower in the NK1 group compared to the ONS group 0–2, 0–24, and 0–48 hours after surgery (2 versus 17%, 2 versus 28%, and 2 versus 29%, resp.). However, no significant differences in PONV, complete response, rescue antiemetic use, and nausea score were observed between groups 0–48 hours after surgery. In moderate to high PONV risk patients, fosaprepitant decreased the incidence of vomiting and was superior to ondansetron in preventing postoperative vomiting 0–48 hours after surgery.

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