WordNet

happening or done after a surgical operation; "postoperative complications"; "postoperative care"
the state that precedes vomiting (同)sickness
disgust so strong it makes you feel sick

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《語・句・節を対等に結んで》…『と』…,…や…,および / 《数詞を結合して》…『足す』…,…に加えて / …『しかも』…,…して,同時に… / 《時間的に》『そして』,それから,すると(and then) / 《当然の帰結として》…『ので』,…だから(and so) / 《おもに話》《命令文などの後で》『そうすれば』,そうしたら / 《追加・強調して》それに,しかも / 《対照的な内容を導いて》ところが,しかし(but) / 《譲歩的に》それなのに,それでいながら / 《A and Bで一体の関係を表して》《単数扱い》 / 《同一語を反復して多数・継続などを表して》 / 《同一の複数名詞を結合して変化・種類などを表して》 / 《話》《「形容詞+and+形容詞」の形で前の形容詞が後に副詞的に働く》 / 《話》《「動詞come, goなど+and+動詞」の形でandとその後の動詞が不定詞の働きをして》 / 《「動詞+and+動詞」の形で後の動詞が現在分詞の意を表して》 / 《話》《文頭において前の質問・意見などに同意を示して》そうとも,そして(Yes!and) / 《話》《文頭に置いて驚き・疑念・非難などを表して》ほんとうに;…なのに
外科手術後の
吐き気 / 強いけんお(loathing)
(次にくる語の発音が母音で始まるときに用いる) / (子音[h]で始まり第1音節に強勢のない語の場合はanを用いることがある.ただし,この場合は[h]を発音しない)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/03/21 23:56:09」(JST)

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[Wiki en表示]

Postoperative nausea and vomiting (PONV) is an unpleasant complication affecting about a third of the 10% of the population undergoing general anaesthesia each year.

Cause

Emetogenic drugs commonly used in anaesthesia include nitrous oxide, physostigmine and opioids. The intravenous anaesthetic propofol is currently the least emetogenic general anaesthetic.

Risk factors

Postoperative nausea and vomiting results from anaesthesic, surgical, and patients factors. Gynaecological, urological, strabismus correction and middle ear surgery all have a higher risk of postoperative nausea and vomiting.

Patients that are female or who have a history of postoperative nausea and vomiting are at greater risk. Smokers have a decreased risk, but this would never be recommended by any physician. Older patients suffer less PONV.

Obesity, age less than 16 years, past history of motion sickness and high levels of pre-operative anxiety are also risk factors for PONV.

Management

Because no currently available antiemetic is especially effective by itself, and successful control is often elusive, experts recommend a multimodal approach. Anaesthetic strategies to prevent vomiting include using regional anaesthesia wherever possible and avoiding medications that cause vomiting. Medications to treat and prevent postoperative nausea and vomiting is limited by both cost and the adverse effects. People with risk factors probably warrant preventative medication, whereas a "wait and see" strategy is appropriate for those without risk factors.

Medications

A Cochrane review found droperidol, metoclopramide, ondansetron, tropisetron, dolasetron, dexamethasone, cyclizine, and granisetron effective for preventing PONV.^[1]

Granisetron and dexamethasone is not recommended due to the higher rate of side effects.^[2]

Alternative medicine

In conjunction with antiemetic medications, at least one study has found that application to the Pericardium Meridian 6 accupressure point produced a positive effect in relieving postoperative nausea and vomiting.^[3] Another study found no statistically significant difference.^[4]

Epidemiology

On average the incidence of nausea or vomiting after general anesthesia ranges between 25 and 30% [Cohen 1994]. Nausea and vomiting can be extremely distressing for patients and is therefore one of their major concerns [Macario 1999]. Vomiting has been associated with major complications such as pulmonary aspiration of gastric content and might endanger surgical outcomes after certain procedures, for example after maxillofacial surgery with wired jaws. Nausea and vomiting can delay discharge and about 1% of patients scheduled for day surgery require unanticipated overnight admission because of uncontrolled postoperative nausea and vomiting.

References

^ Carlisle, JB; Stevenson, CA (19 July 2006). "Drugs for preventing postoperative nausea and vomiting.". The Cochrane database of systematic reviews (3): CD004125. doi:10.1002/14651858.CD004125.pub2. PMID 16856030.
^ Tricco, AC; Soobiah, C; Blondal, E; Veroniki, AA; Khan, PA; Vafaei, A; Ivory, J; Strifler, L; Ashoor, H; MacDonald, H; Reynen, E; Robson, R; Ho, J; Ng, C; Antony, J; Mrklas, K; Hutton, B; Hemmelgarn, BR; Moher, D; Straus, SE (18 June 2015). "Comparative safety of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis.". BMC medicine 13: 142. doi:10.1186/s12916-015-0379-3. PMC 4472408. PMID 26084332.
^ "Accupressure Treatment For The Prevention Of Postoperative Nausea And Vomiting" (PDF).
^ "Effect of acupressure on postoperative nausea and vomiting in laparoscopic cholecystectomy.".

UpToDate Contents

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1. 麻酔後ケア病棟における合併症発生の概要 overview of complications occurring in the post anesthesia care unit
2. 悪心および嘔吐を伴う成人に対するアプローチ approach to the adult with nausea and vomiting
3. 制吐剤の特性 characteristics of antiemetic drugs
4. 婦人科外科手術の合併症 complications of gynecologic surgery
5. 小児における扁桃摘出（アデノイド切除同時施行例を含む）：術後ケアおよび合併症 tonsillectomy with or without adenoidectomy in children postoperative care and complications

English Journal

Acupuncture for cancer pain and related symptoms.

Lu W, Rosenthal DS.SourceLeonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA, weidong_lu@dfci.harvard.edu.
Current pain and headache reports.Curr Pain Headache Rep.2013 Mar;17(3):321. doi: 10.1007/s11916-013-0321-3.
Cancer pain is one of most prevalent symptoms in patients with cancer. Acupuncture and related techniques have been suggested for the management of cancer pain. The National Comprehensive Cancer Network guidelines for adult cancer pain recommends acupuncture, as one of several integrative interventi
PMID 23338773

Wound infusion of bupivacaine following radical retropubic prostatectomy: a randomised placebo-controlled clinical study.

Kristensen BS, Fenger-Eriksen C, Pedersen KV, Felsby S.SourceFrom the Department of Anaesthesiology and Intensive Care (BSK, CF-E, SF), Department of Urology, Aarhus University Hospital Skejby, Skejby, Aarhus, Denmark (KVP).
European journal of anaesthesiology.Eur J Anaesthesiol.2013 Mar;30(3):124-8. doi: 10.1097/EJA.0b013e32835c6f25.
CONTEXT: The effectiveness of postoperative analgesia through a wound catheter is subject to considerable debate.OBJECTIVE: To test the hypothesis that local wound infusion with bupivacaine followed by continuous infusion could reduce postoperative need for opioids in patients undergoing retropubic
PMID 23318812

Japanese Journal

Incidence of and Risk Factors for Postoperative Nausea and Vomiting at a Japanese Cancer Center: First Large-Scale Study in Japan

森野良蔵
東京女子医科大学雑誌 83(2), 141-142, 2013-04-25
NAID 120005302561

胸腔鏡下肺癌手術に対する術後鎮痛法の検討

梶山誠司,加藤貴大,濱田宏 [他],河本昌志
The journal of the Japan Society of Pain Clinicians = 日本ペインクリニック学会誌 19(4), 470-474, 2012-10-25
… We conducted a retrospective study to evaluate the postoperative analgesic efficacy and side effects of two common analgesic techniques in patients undergoing video-assisted thoracic surgery (VATS) for lung cancer. …
NAID 10031127000

Postoperative continuous intravenous infusion of fentanyl is associated with the development of orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery.

Iwata Yoshika,Mizota Yoko,Mizota Toshiyuki,Koyama Tomohiro,Shichino Tsutomu
Journal of anesthesia 26(4), 503-508, 2012-08-20
… however, orthostatic intolerance may delay recovery and cause syncope, leading to potential serious complications such as falls. … Opioids may contribute to orthostatic intolerance because of reduced arterial pressure and associated reduction in cerebral blood flow and oxygenation. …
NAID 10031070161

Related Pictures

★リンクテーブル★

リンク元	「postoperative nausea」「postoperative vomiting」「術後悪心嘔吐」「PONV」
関連記事	「postoperative」「postoperative nausea」