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DOI: 10.1055/s-2002-35000
Postoperative Übelkeit und Erbrechen in der Hals-, Nasen- und Ohrenheilkunde. Pathophysiologie, Therapie und Prophylaxe
Eine ÜbersichtPostoperative Nausea and Vomiting - Pathophysiology, Prophylaxis and Treatment A ReviewPublication History
Eingegangen: 16. November 2001
Angenommen: 6. Februar 2002
Publication Date:
24 October 2002 (online)
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Zusammenfassung
Postoperative Übelkeit und Erbrechen (PONV) ist eine der häufigsten Komplikationen bei operativen Eingriffen in der Hals-, Nasen- und Ohrenheilkunde. Abhängig von prädisponierenden Faktoren des Patienten, der Art des Eingriffes und dem anästhesiologischen Verfahren können Inzidenzen von über 70 % beobachtet werden. Dies kann zu erheblichen medizinischen, organisatorischen und vor allem ökonomischen Problemen führen. Bei so genannten Hochrisiko-Patienten wird daher neben einem adäquaten anästhesiologischen und operativen Management eine gezielte antiemetische Prophylaxe empfohlen. Medikamente aus der Gruppe der 5-HT3-Rezeptor-Antagonisten erscheinen hierbei als besonders effektiv. Dieser Artikel soll eine Übersicht über Ursachen, Prävention und Management von postoperativer Übelkeit und Erbrechen in der Hals-, Nasen- und Ohrenheilkunde geben.
Abstract
Postoperative nausea and vomiting (PONV) are among the most common complications in operative medicine. Especially patients undergoing middle ear surgery or adenotonsillectomy are frequently associated with PONV (70 %). Furthermore, emesis carries the risk of severe postoperative complications and is associated with additional costs and distress in patient management. If the patient carries a high risk for postoperative emesis, the patient should receive a prophylactic antiemetic therapy. 5-HT3 receptor antagonists are highly effective in prevention and management of PONV. This review will discuss pathophysiology, prophylaxis and treatment of postoperative nausea and vomiting after E.N.T. surgery.
Schlüsselwörter
PONV - Erbrechen - Übelkeit - HNO - Tonsillektomien - Pathophysiologie - Prophylaxe - Ökonomie
Key words
PONV - Vomiting - Nausea - E.N.T. - Tonsillectomy - Pathophysiology - Prophylaxis - 5-HT3 receptor antagonists - Economy
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