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首页> 外文期刊>Current opinion in anaesthesiology >The role of neurokinin-1 receptor antagonists for the management of postoperative nausea and vomiting.
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The role of neurokinin-1 receptor antagonists for the management of postoperative nausea and vomiting.

机译：神经激肽-1受体拮抗剂在术后恶心和呕吐管理中的作用。

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PURPOSE OF REVIEW: To review the characteristics of neurokinin-1 receptor antagonists and their potential role in the management of postoperative nausea and vomiting. RECENT FINDINGS: Neurokinin-1 antagonists compete with substance P, an endogenous ligand with a high density of receptors in the area postrema and the nucleus tractus solitarii, believed to be involved in terminal emetic pathways. Experimental data provide evidence for efficacy against a wide range of peripheral and central emetic stimuli and clinical trials confirm that neurokinin-1 antagonists have significantly higher efficacy against vomiting than all other antiemetics, with relative risk reductions of over 50%. In fact, aprepitant - the first neurokinin-1 antagonist approved by the US Food and Drug Administration - provides superior protection against postoperative vomiting compared with ondansetron, and the same appears to be true for other drugs of this class. However, efficacy against nausea does not appear to be superior to otherantiemetics, so that composite outcomes that are driven by nausea (e.g. complete response) disguise the unique anti-vomiting efficacy. SUMMARY: Postoperative vomiting can lead to rare but serious complications. Neurokinin-1 receptor antagonists are significantly more efficacious against postoperative vomiting than other antiemetics. Because the benefit in terms of absolute risk reduction is critically dependent on the patient's baseline risk, it is recommended to use a validated risk score to identify patients who will benefit most from prophylaxis using neurokinin-1 receptor antagonists.
机译：审查目的：审查神经激肽-1受体拮抗剂的特征及其在术后恶心和呕吐的管理中的潜在作用。最近的发现：Neurokinin-1拮抗剂与P物质竞争，P物质是一种在视网膜后和孤立核中具有高密度受体的内源性配体，被认为与终末催吐途径有关。实验数据提供了对广泛的外周和中枢催吐刺激功效的证据，临床试验证实，神经激肽-1拮抗剂对呕吐的功效明显高于所有其他止吐药物，相对风险降低了50％以上。实际上，aprepitant是美国食品和药物管理局批准的第一种神经激肽1拮抗剂，与恩丹西酮相比，能为术后呕吐提供更好的保护，并且对于该类其他药物也是如此。然而，对抗恶心的功效似乎并不优于其他止吐药，因此由恶心驱动的复合结果（例如完全反应）掩盖了独特的抗呕吐功效。摘要：术后呕吐可导致罕见但严重的并发症。 Neurokinin-1受体拮抗剂比其他止吐药对术后呕吐的功效明显更高。因为就绝对风险降低而言，收益绝对取决于患者的基线风险，所以建议使用经过验证的风险评分来确定从使用神经激肽-1受体拮抗剂的预防中受益最大的患者。

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