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intensiv 2010; 18(6): 284-290
DOI: 10.1055/s-0030-1268012
Schwerpunkt: Arbeitsfeld Anästhesie
© Georg Thieme Verlag KG Stuttgart · New York

Prophylaxe und Therapie von Übelkeit und Erbrechen nach Narkosen (PONV)

Leopold H. J. Eberhart, Dirk Rüsch
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Publication History

Publication Date:
01 November 2010 (online)

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Zusammenfassung

In den letzten Jahren gab es zahlreiche neue Erkenntnisse zur Prophylaxe und Therapie von Übelkeit und Erbrechen in der postoperativen Phase (Postoperative nausea and vomiting: PONV). Erwähnenswert ist dabei die Verfügbarkeit einer komplett neuen antiemetischen Intervention – dem Neurokininantagonisten Aprepitant – sowie die Wiederzulassung von Droperidol, einem seit vielen Jahrzehnten bewährten Dopaminantagonisten. Neu ist zudem eine mittlerweile eher kritische Bewertung eines risikoadaptiertes Vorgehens, basierend auf vereinfachten Risiko-Scores. Die Anwendung solcher Prädikationsmodelle wird vor allem aufgrund der sehr ungenauen Prädiktion des individuellen Risikos als auch aufgrund von Problemen bei der Implementierung eines risikoadaptierten Vorgehens nicht mehr uneingeschränkt empfohlen. Vielmehr geht der Trend klar zu einer liberalen Applikation von Antiemetika, die zudem viel häufiger als multimodale Prophylaxe bzw. Therapie verabreicht werden sollte. Da es keine spezifischen Spezialindikationen für das eine oder andere Antiemetikum gibt, sollte die Auswahl der antiemetischen Interventionen primär anhand der potenziellen Nebenwirkungen getroffen werden. Zu beachten ist allerdings, dass eine TIVA später nicht mehr „nachgeholt” werden kann. Kortikosteroide (Dexamethason) sollten wegen eines verzögerten Wirkeintritts eher am Anfang einer Operation verabreicht werden. 5-HT3-Antagonisten eignen sich gut zur Behandlung auf peripheren Stationen, da meist eine geringere Hemmschwelle bei der Applikation dieser Substanzen vorhanden ist. Droperidol ist nur in Anästhesiekreisen verbreitet und stellt neben Dexamethason somit intraoperativ die Prophylaxe der ersten Wahl dar. PONV kann gut und mit vertretbarem Aufwand weitgehend eliminiert werden. Neben „schmerzfreien” Krankenhäusern sollte als weiteres Ziel nun das PONV-freie Krankenhaus auf der Agenda stehen.

Literatur

  • 01 Apfel C C, Laara E , Koivuranta M et al.. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers.  Anesthesiology. 1999;  91 693-700
    Google Scholar
  • 02 Lohr K N. Outcome measurement: concepts and questions.  Inquiry. 1988;  25 37-50
    Google Scholar
  • 03 Macario A , Weinger M , Carney S  et al.. Which clinical anesthesia outcomes are important to avoid? The perspective of patients.  Anesth Analg. 1999;  89 652-658
    Google Scholar
  • 04 Eberhart L H, Mauch M , Morin A M et al.. Impact of a multimodal anti-emetic prophylaxis on patient satisfaction in high-risk patients for postoperative nausea and vomiting.  Anaesthesia. 2002;  57 1022-1027
    Google Scholar
  • 05 Eberhart L H, Morin A M, Wulf H  et al.. Patient preferences for immediate postoperative recovery.  Br J Anaesth. 2002;  89 760-761
    Google Scholar
  • 06 Myles P S, Williams D L, Hendrata M  et al.. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients.  Br J Anaesth. 2000;  84 6-10
    Google Scholar
  • 07 Blacoe D A, Cunning E , Bell G . Paediatric day-case surgery: an audit of unplanned hospital admission Royal Hospital for Sick Children, Glasgow.  Anaesthesia. 2008;  63 610-615
    Google Scholar
  • 08 Baric A . Oesophageal rupture in a patient with postoperative nausea and vomiting.  Anaesth Intensive Care. 2000;  28 325-327
    Google Scholar
  • 09 Atallah F N, Riu B M, Nguyen L B et al.. Boerhaave‘s syndrome after postoperative vomiting.  Anesth Analg. 2004;  98 1164-1166 table of contents
    Google Scholar
  • 10 Toprak V , Keles G T, Kaygisiz Z  et al.. Subcutaneous emphysema following severe vomiting after emerging from general anesthesia.  Acta Anaesthesiol Scand. 2004;  48 917-918
    CrossrefGoogle Scholar
  • 11 Irefin S A, Farid I S, Senagore A J. Urgent colectomy in a patient with membranous tracheal disruption after severe vomiting.  Anesth Analg. 2000;  91 1300-1302
    CrossrefGoogle Scholar
  • 12 Macario A , Weinger M , Truong P  et al.. Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expert anesthesiologists.  Anesth Analg. 1999;  88 1085-1091
    CrossrefGoogle Scholar
  • 13 Apfel C C, Kranke P, Piper S et al.. Nausea and vomiting in the postoperative phase. Expert- and evidence-based recommendations for prophylaxis and therapy.  Anaesthesist. 2007;  56 1170-1180
    CrossrefGoogle Scholar
  • 14 Gan T J, Meyer T A, Apfel C C. Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting.  Anesth Analg. 2007;  105 1615-1628
    CrossrefGoogle Scholar
  • 15 Cohen M M, Duncan P G, DeBoer D P et al.. The postoperative interview: assessing risk factors for nausea and vomiting.  Anesth Analg. 1994;  78 7-16
    Google Scholar
  • 16 Koivuranta M, Laara E, Snare L et al.. A survey of postoperative nausea and vomiting.  Anaesthesia. 1997;  52 443-449
    CrossrefGoogle Scholar
  • 17 Stadler M, Bardiau F, Seidel L et al.. Difference in risk factors for postoperative nausea and vomiting.  Anesthesiology. 2003;  98 46-52
    CrossrefPubMedGoogle Scholar
  • 18 Palazzo M, Evans R. Logistic regression analysis of fixed patient factors for postoperative sickness: a model for risk assessment.  Br J Anaesth. 1993;  70 135-140
    CrossrefGoogle Scholar
  • 19 Apfel C C, Greim C A, Haubitz I et al.. The discriminating power of a risk score for postoperative vomiting in adults undergoing various types of surgery.  Acta Anaesthesiol Scand. 1998;  42 502-509
    CrossrefGoogle Scholar
  • 20 Eberhart L H, Hogel J, Seeling W et al.. Evaluation of three risk scores to predict postoperative nausea and vomiting.  Acta Anaesthesiol Scand. 2000;  44 480-488
    CrossrefGoogle Scholar
  • 21 Apfel C C, Kranke P, Eberhart L H et al.. Comparison of predictive models for postoperative nausea and vomiting.  Br J Anaesth. 2002;  88 234-240
    CrossrefGoogle Scholar
  • 22 Apfel C C, Kranke P, Eberhart L H. Comparison of surgical site and patient‘s history with a simplified risk score for the prediction of postoperative nausea and vomiting.  Anaesthesia. 2004;  59 1078-1082
    CrossrefGoogle Scholar
  • 23 Sinclair D R, Chung F, Mezei G. Can postoperative nausea and vomiting be predicted?.  Anesthesiology. 1999;  91 109-118
    CrossrefGoogle Scholar
  • 24 Junger A, Hartmann B, Benson M et al.. The use of an anesthesia information management system for prediction of antiemetic rescue treatment at the postanesthesia care unit.  Anesth Analg. 2001;  92 1203-1209
    CrossrefPubMedGoogle Scholar
  • 25 Choi D H, Ko J S, Ahn H J et al.. A korean predictive model for postoperative nausea and vomiting.  J Korean Med Sci. 2005;  20 811-815
    CrossrefGoogle Scholar
  • 26 Toner C C, Broomhead C J, Littlejohn I H et al.. Prediction of postoperative nausea and vomiting using a logistic regression model.  Br J Anaesth. 1996;  76 347-351
    Google Scholar
  • 27 Apfel C C, Kranke P, Eberhart L H et al.. Comparison of predictive models for postoperative nausea and vomiting.  Br J Anaesth. 2002;  88 234-240
    CrossrefGoogle Scholar
  • 28 Eberhart L H, Geldner G, Kranke P et al.. The development and validation of a risk score to predict the probability of postoperative vomiting in pediatric patients.  Anesth Analg. 2004;  99 1630-1637
    Google Scholar
  • 29 Song D, Greilich N B, White P F et al.. Recovery profiles and costs of anesthesia for outpatient unilateral inguinal herniorrhaphy.  Anesth Analg. 2000;  91 876-881
    CrossrefPubMedGoogle Scholar
  • 30 Apfel C C, Kranke P, Katz M H. Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design.  Br J Anaesth. 2002;  88 659-668
    CrossrefGoogle Scholar
  • 31 Apfel C C, Korttila K, Abdalla M et al.. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting.  N Engl J Med. 2004;  350 2441-2451
    CrossrefGoogle Scholar
  • 32 Tramer M, Moore A, McQuay H. Omitting nitrous oxide in general anaesthesia: meta-analysis of intraoperative awareness and postoperative emesis in randomized controlled trials.  Br J Anaesth. 1996;  76 186-193
    Google Scholar
  • 33 Marret E, Kurdi O, Zufferey P et al.. Effects of nonsteroidal antiinflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials.  Anesthesiology. 2005;  102 1249-1260
    CrossrefGoogle Scholar
  • 34 Roberts G W, Bekker T B, Carlsen H H et al.. Postoperative nausea and vomiting are strongly influenced by postoperative opioid use in a dose-related manner.  Anesth Analg. 2005;  101 1343-1348
    CrossrefPubMedGoogle Scholar
  • 35 Eberhart L H, Morin A M, Georgieff M. Dexamethasone for prophylaxis of postoperative nausea and vomiting. A meta-analysis of randomized controlled studies.  Anaesthesist. 2000;  49 713-720
    CrossrefGoogle Scholar
  • 36 Henzi I, Walder B, Tramer M R. Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review.  Anesth Analg. 2000;  90 186-194
    CrossrefGoogle Scholar
  • 37 Carlisle J B, Stevenson C A. Drugs for preventing postoperative nausea and vomiting.  Cochrane Database Syst Rev 2006;  (3) CD004125
    Google Scholar
  • 38 Karanicolas P J, Smith S E, Kanbur B et al.. The impact of prophylactic dexamethasone on nausea and vomiting after laparoscopic cholecystectomy: a systematic review and meta-analysis.  Ann Surg. 2008;  248 751-762
    CrossrefGoogle Scholar
  • 39 Wang J J, Ho S T, Tzeng J I. The effect of timing of dexamethasone administration on its efficacy as a prophylactic antiemetic for postoperative nausea and vomiting.  Anesth Analg. 2000;  91 136-139
    CrossrefGoogle Scholar
  • 40 Tramer M R, Reynolds D J, Moore R A et al.. Efficacy, dose-response, and safety of ondansetron in prevention of postoperative nausea and vomiting: a quantitative systematic review of randomized placebo-controlled trials.  Anesthesiology. 1997;  87 1277-1289
    CrossrefGoogle Scholar
  • 41 Eberhart L H, Morin A M, Bothner U et al.. Droperidol and 5-HT3-receptor antagonists, alone or in combination, for prophylaxis of postoperative nausea and vomiting. A meta-analysis of randomised controlled trials.  Acta Anaesthesiol Scand. 2000;  44 1252-1257
    CrossrefGoogle Scholar
  • 42 Sun R, Klein, K W, White P F. The effect of timing of ondansetron administration in outpatients undergoing otolaryngologic surgery.  Anesth Analg. 1997;  84 331-336
    CrossrefGoogle Scholar
  • 43 Candiotti K A, Kovac A L, Melson T I et al.. A randomized, double-blind study to evaluate the efficacy and safety of three different doses of palonosetron versus placebo for preventing postoperative nausea and vomiting.  Anesth Analg. 2008;  107 445-451
    CrossrefGoogle Scholar
  • 44 Kovac A L, Eberhart L, Kotarski J et al.. A randomized, double-blind study to evaluate the efficacy and safety of three different doses of palonosetron versus placebo in preventing postoperative nausea and vomiting over a 72-hour period.  Anesth Analg. 2008;  107 439-444
    CrossrefGoogle Scholar
  • 45 Henzi I, Sonderegger J, Tramer M R. Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting.  Can J Anaesth. 2000;  47 537-5351
    CrossrefGoogle Scholar
  • 46 Rosow C E, Haspel K L, Smith S E et al.. Haloperidol versus ondansetron for prophylaxis of postoperative nausea and vomiting.  Anesth Analg. 2008;  2008 1407-1409
    Google Scholar
  • 47 Lee Y, Wang P K, Lai H Y et al.. Haloperidol is as effective as ondansetron for preventing postoperative nausea and vomiting.  Can J Anaesth. 2007;  54 349-354
    CrossrefGoogle Scholar
  • 48 Yang Y L, Lai H Y, Wang J J et al.. The timing of haloperidol administration does not affect its prophylactic antiemetic efficacy.  Can J Anaesth. 2008;  55 270-275
    CrossrefGoogle Scholar
  • 49 Henzi I, Walder B, Tramer M R. Metoclopramide in the prevention of postoperative nausea and vomiting: a quantitative systematic review of randomized, placebo-controlled studies.  Br J Anaesth. 1999;  83 761-771
    Google Scholar
  • 50 Domino K B, Anderson E A, Polissar N L. Comparative efficacy and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting: a meta-analysis.  Anesth Analg. 1999;  88 1370-1379
    CrossrefGoogle Scholar
  • 51 Wallenborn J, Gelbrich G, Bulst D. Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone: randomised double blind multicentre trial.  Bmj. 2006;  333 324
    CrossrefGoogle Scholar
  • 52 Kranke P, Morin A M, Roewer N et al.. Dimenhydrinate for prophylaxis of postoperative nausea and vomiting: a meta-analysis of randomized controlled trials.  Acta Anaesthesiol Scand. 2002;  46 238-244
    CrossrefGoogle Scholar
  • 53 Kranke P, Morin A M, Roewer N et al.. The efficacy and safety of transdermal scopolamine for the prevention of postoperative nausea and vomiting: a quantitative systematic review.  Anesth Analg. 2002;  95 133-143
    CrossrefGoogle Scholar
  • 54 Gan T J, Apfel C C, Kovac A et al.. A randomized, double-blind comparison of the NK1 antagonist, aprepitant, versus ondansetron for the prevention of postoperative nausea and vomiting.  Anesth Analg. 2007;  140 1082-1089
    Google Scholar
  • 55 Diemunsch P, Gan T J, Philip B K et al.. Single-dose aprepitant vs ondansetron for the prevention of postoperative nausea and vomiting: a randomized, double-blind phase III trial in patients undergoing open abdominal surgery.  Br J Anaesth. 2007;  99 202-211
    CrossrefGoogle Scholar
  • 56 Bauer K P, Dom P M, Ramirez A M et al.. Preoperative intravenous midazolam: benefits beyond anxiolysis.  J Clin Anesth. 2004;  16 177-183
    CrossrefGoogle Scholar
  • 57 Sanjay O P, Tauro D I. Midazolam: an effective antiemetic after cardiac surgery--a clinical trial.  Anesth Analg. 2004;  99 339-343
    Google Scholar
  • 58 Lee Y, Wang J J, Yang Y L et al.. Midazolam vs ondansetron for preventing postoperative nausea and vomiting: a randomised controlled trial.  Anaesthesia. 2007;  62 18-22
    CrossrefGoogle Scholar
  • 59 Jung J S, Park J S, Kim S O et al.. Prophylactic antiemetic effect of midazolam after middle ear surgery.  Otolaryngol Head Neck Surg. 2007;  137 753-756
    CrossrefGoogle Scholar
  • 60 Khalil S, Philbrook L, Rabb M et al.. Ondansetron/promethazine combination or promethazine alone reduces nausea and vomiting after middle ear surgery.  J Clin Anesth. 1999;  11 596-600
    CrossrefGoogle Scholar
  • 61 Chia Y Y, Lo Y, Liu K et al.. The effect of promethazine on postoperative pain: a comparison of preoperative, postoperative, and placebo administration in patients following total abdominal hysterectomy.  Acta Anaesthesiol Scand. 2004;  48 625-630
    CrossrefGoogle Scholar
  • 62 Glaser C, Sitzwohl C, Wallner T et al.. Dixyrazine for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy.  Acta Anaesthesiol Scand. 2004;  48 1287-1291
    CrossrefGoogle Scholar
  • 63 Navari R M, Einhorn L H, Loehrer P J et al.. A phase II trial of olanzapine, dexamethasone, and palonosetron for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier oncology group study.  Support Care Cancer. 2007;  15 1285-1291
    CrossrefGoogle Scholar
  • 64 Chen C C, Lin C S, Ko Y P et al.. Premedication with mirtazapine reduces preoperative anxiety and postoperative nausea and vomiting.  Anesth Analg. 2008;  106 109-113
    CrossrefGoogle Scholar
  • 65 Lewis I H, Campbell D N, Barrowcliffe M P. Effect of nabilone on nausea and vomiting after total abdominal hysterectomy.  Br J Anaesth. 1194;  73 244-246
    Google Scholar
  • 66 Oddby-Muhrbeck E, Eksborg S, Bergendahl H T et al.. Effects of clonidine on postoperative nausea and vomiting in breast cancer surgery.  Anesthesiology. 2002;  96 1109-1114
    CrossrefGoogle Scholar
  • 67 Orhan-Sungur M, Kranke P, Sessler D et al.. Does supplemental oxygen reduce postoperative nausea and vomiting? A meta-analysis of randomized controlled trials.  Anesth Analg. 2008;  106 1733-1738
    CrossrefGoogle Scholar
  • 68 Morin A M, Betz O, Kranke P. Is ginger a relevant antiemetic for postoperative nausea and vomiting?.  Anasthesiol Intensivmed Notfallmed Schmerzther. 2004;  39 281-285
    Article in Thieme ConnectGoogle Scholar
  • 69 Teran L, Hawkins J K. The effectiveness of inhalation isopropyl alcohol vs. granisetron for the prevention of postoperative nausea and vomiting.  Aana J. 2007;  75 417-422
    Google Scholar
  • 70 Ali S Z, Taguchi A, Holtmann B   et al.. Effect of supplemental pre-operative fluid on postoperative nausea and vomiting.  Anaesthesia. 2003;  58 780-784
    CrossrefGoogle Scholar
  • 71 Magner J J, McCaul C, Carton C et al.. Effect of intraoperative intravenous crystalloid infusion on postoperative nausea and vomiting after gynaecological laparoscopy: comparison of 30 and 10 ml kg(-1).  Br J Anaesth. 2004;  93 381-385
    CrossrefGoogle Scholar
  • 72 Maharaj C H, Kallam S R, Malik A et al.. Preoperative intravenous fluid therapy decreases postoperative nausea and pain in high risk patients.  Anesth Analg. 2005;  100 675-682
    CrossrefGoogle Scholar
  • 73 Dagher C F, Abboud B, Richa F et al.. Effect of intravenous crystalloid infusion on postoperative nausea and vomiting after thyroidectomy: a prospective, randomized, controlled study.  Eur J Anaesthesiol. 2009;  26 188-191
    CrossrefGoogle Scholar
  • 74 Lee A, Done M L. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting.  Cochrane Database Syst Rev 2004;  (3) CD003281
    Google Scholar
  • 75 Lee A, Fan L T. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting.  Cochrane Database Syst Rev 2009;  (2) CD003281
    Google Scholar
  • 76 Abraham J. Acupressure and acupuncture in preventing and managing postoperative nausea and vomiting in adults.  J Perioper Pract. 2008;  18 543-551
    Google Scholar
  • 77 Scuderi P E, James R L, Harris L et al.. 3rd,Multimodal antiemetic management prevents early postoperative vomiting after outpatient laparoscopy.  Anesth Analg. 2000;  91 1408-1414
    CrossrefGoogle Scholar
  • 78 Eberhart L H, Frank S, Lange H et al.. Systematic review on the recurrence of postoperative nausea and vomiting after a first episode in the recovery room - implications for the treatment of PONV and related clinical trials.  BMC Anesthesiol. 2006;  6 14
    CrossrefGoogle Scholar
  • 79 Kazemi-Kjellberg F, Henzi I, Tramer M R. Treatment of established postoperative nausea and vomiting: a quantitative systematic review.  BMC Anesthesiol. 2001;  1 2
    CrossrefGoogle Scholar
  • 80 Rusch D, Arndt C, Martin H et al.. The addition of dexamethasone to dolasetron or haloperidol for treatment of established postoperative nausea and vomiting.  Anaesthesia. 2007;  62 810-817
    CrossrefGoogle Scholar
  • 81 Habib A S, Gan T J. The effectiveness of rescue antiemetics after failure of prophylaxis with ondansetron or droperidol: a preliminary report.  J Clin Anesth. 2005;  14 62-65
    Google Scholar
  • 82 Habib A J, Reuveni J, Taguchi A et al.. A comparison of ondansetron with promethazine for treating postoperative nausea and vomiting in patients who received prophylaxis with ondansetron: a retrospective database analysis.  Anesth Analg. 2007;  104 548-551
    CrossrefGoogle Scholar
  • 83 Kovac A L, O’Connor T A, Pearman M H et al.. Efficacy of repeat intravenous dosing of ondansetron in controlling postoperative nausea and vomiting: a randomized, double-blind, placebo-controlled multicenter trial.  J Clin Anesth. 1999;  11 453-459
    CrossrefGoogle Scholar
  • 84 Sossai R, Johr M, Kistler M et al.. Postoperative vomiting in children. A persisting unsolved problem.  Eur J Pediatr Surg. 1993;  3 206-208
    Article in Thieme ConnectGoogle Scholar
  • 85 Eberhart L H, Morin A M, Guber D et al.. Applicability of risk scores for postoperative nausea and vomiting in adults to paediatric patients.  Br J Anaesth. 2004;  93 386-392
    CrossrefGoogle Scholar
  • 86 Czarnetzki C, Elia N, Lysakowski C et al.. Dexamethasone and risk of nausea and vomiting and postoperative bleeding after tonsillectomy in children: a randomized trial.  Jama. 2008;  300 2621-2630
    CrossrefGoogle Scholar
  • 87 Tramer M R, Walder B. Efficacy and adverse effects of prophylactic antiemetics during patient-controlled analgesia therapy: a quantitative systematic review.  Anesth Analg. 1999;  88 1354-1361
    CrossrefGoogle Scholar
  • 88 Hopkins D, Shipton E A, Potgieter D et al.. Comparison of tramadol and morphine via subcutaneous PCA following major orthopaedic surgery.  Can J Anaesth . 1998;  45 435-442
    CrossrefGoogle Scholar
  • 89 Pang W W, Mok M S, Lin C H et al.. Comparison of patient-controlled analgesia (PCA) with tramadol or morphine.  Can J Anaesth. 1999;  46 1030-1035
    CrossrefGoogle Scholar
  • 90 Silvasti M, Svartling N, Pitkanen M et al.. Comparison of intravenous patient-controlled analgesia with tramadol versus morphine after microvascular breast reconstruction.  Eur J Anaesthesiol. 2000;  17 448-455
    Google Scholar
  • 91 Erolcay H, Yuceyar L. Intravenous patient-controlled analgesia after thoracotomy: a comparison of morphine with tramadol.  Eur J Anaesthesiol. 2003;  20 141-146
    CrossrefGoogle Scholar
  • 92 Casali R, Lepri A, Cantini Q et al.. Comparative study of the effects of morphine and tramadol in the treatment of postoperative pain.  Minerva Anestesiol. 2000;  66 147-152
    Google Scholar
  • 93 Sudheer P S, Logan S W, Terblanche C et al.. Comparison of the analgesic efficacy and respiratory effects of morphine, tramadol and codeine after craniotomy.  Anaesthesia. 2007;  62 555-560
    CrossrefGoogle Scholar
  • 94 Hadi M A, Kamaruljan H S, Saedah A et al.. A comparative study of intravenous patient-controlled analgesia morphine and tramadol in patients undergoing major operation.  Med J Malaysia. 2006;  61 570-576
    Google Scholar
  • 95 Dingus D J, Sherman J C, Rogers D A et al.. Buprenorphine versus morphine for patient-controlled analgesia after cholecystectomy.  Surg Gynecol Obstet. 1993;  177 1-6
    Google Scholar
  • 96 Capogna G, Celleno D, Sebastiani M et al.. Continuous intravenous infusion with patient-controlled anesthesia for postoperative analgesia in cesarean section: morphine versus buprenorphine.  Minerva Anestesiol. 1989;  55 33-38
    Google Scholar
  • 97 Ho S T, Wang J J, Liu H S et al.. The analgesic effect of PCA buprenorphine in Taiwan’s gynecologic patients.  Acta Anaesthesiol Sin. 1997;  35 195-199
    Google Scholar
  • 98 Harmer M, Slattery P J, Rosen M et al.. Intramuscular on demand analgesia: double blind controlled trial of pethidine, buprenorphine, morphine, and meptazinol.  Br Med J (Clin Res Ed). 1983;  286 680-682
    CrossrefGoogle Scholar
  • 99 Dopfmer U R, Schenk M R, Kuscic S et al.. A randomized controlled double-blind trial comparing piritramide and morphine for analgesia after hysterectomy.  Eur J Anaesthesiol. 2001;  18 389-393
    CrossrefGoogle Scholar
  • 100 Breitfeld C, Peters J, Vockel T et al.. Emetic effects of morphine and piritramide.  Br J Anaesth. 2003;  91 218-223
    CrossrefGoogle Scholar
  • 101 Coda B A, O’Sullivan B, Donaldson G et al.. Comparative efficacy of patient-controlled administration of morphine, hydromorphone, or sufentanil for the treatment of oral mucositis pain following bone marrow transplantation.  Pain. 1997;  72 333-346
    CrossrefGoogle Scholar
  • 102 Rapp S E, Egan K J, Ross B K et al.. A multidimensional comparison of morphine and hydromorphone patient-controlled analgesia.  Anesth Analg. 1996;  82 1043-1048
    CrossrefGoogle Scholar
  • 103 Silvasti M, Rosenberg P, Seppala T et al.. Comparison of analgesic efficacy of oxycodone and morphine in postoperative intravenous patient-controlled analgesia.  Acta Anaesthesiol Scand. 1998;  42 576-580
    CrossrefGoogle Scholar
  • 104 Kucukemre F, Kunt N, Kaygusuz K et al.. Remifentanil compared with morphine for postoperative patient-controlled analgesia after major abdominal surgery: a randomized controlled trial.  Eur J Anaesthesiol. 2005;  22 378-385
    CrossrefGoogle Scholar
  • 105 Gurbet A, Goren S, Sahin S et al.. Comparison of analgesic effects of morphine, fentanyl, and remifentanil with intravenous patient-controlled analgesia after cardiac surgery.  J Cardiothorac Vasc Anesth. 2004;  18 755-758
    CrossrefGoogle Scholar
  • 106 Howell P R, Gambling D R, Pavy T et al.. Patient-controlled analgesia following caesarean section under general anaesthesia: a comparison of fentanyl with morphine.  Can J Anaesth. 1995;  42 41-45
    CrossrefGoogle Scholar
  • 107 Castro C, Tharmaratnam U, Brockhurst N. Patient-controlled analgesia with fentanyl provides effective analgesia for second trimester labour: a randomized controlled study.  Can J Anaesth. 2003;  50 1039-1046
    CrossrefGoogle Scholar
  • 108 Watt J W, Soulsby N R. Fentanyl versus morphine for patient-controlled analgesia.  Anaesthesia. 1995;  50 470-471
    Google Scholar
  • 109 Herrick I A, Ganapathy S, Komar W et al.. Postoperative cognitive impairment in the elderly. Choice of patient-controlled analgesia opioid.  Anaesthesia. 1996;  51 356-360
    CrossrefGoogle Scholar
  • 110 Woodhouse A, Hobbes A F, Mather L E et al.. A comparison of morphine, pethidine and fentanyl in the postsurgical patient-controlled analgesia environment.  Pain. 1996;  64 115-121
    CrossrefGoogle Scholar
  • 111 Ginsberg B, Gil K M, Muir M et al.. The influence of lockout intervals and drug selection on patient-controlled analgesia following gynecological surgery.  Pain. 1995;  62 95-100
    CrossrefGoogle Scholar
  • 112 Lee Y, Lai H Y, Lin P C et al.. A dose ranging study of dexamethasone for preventing patient-controlled analgesia-related nausea and vomiting: a comparison of droperidol with saline.  Anesth Analg. 2004;  98 1066-1071
    Google Scholar
  • 113 Dresner M, Dean S, Lumb A et al.. High-dose ondansetron regimen vs droperidol for morphine patient-controlled analgesia.  Br J Anaesth. 1998;  81 384-386
    Google Scholar
  • 114 Kranke P, Eberhart L H, Gan T J et al.. Algorithms for the prevention of postoperative nausea and vomiting: an efficacy and efficiency simulation.  Eur J Anaesthesiol. 2007;  24 856-867
    CrossrefGoogle Scholar
  • 115 Biedler A, Wermelt J, Kunitz O et al.. A risk adapted approach reduces the overall institutional incidence of postoperative nausea and vomiting.  Can J Anaesth. 2004;  51 13-19
    CrossrefPubMedGoogle Scholar
  • 116 Pierre S, Corno G, Benais H. A risk score-dependent antiemetic approach effectively reduces postoperative nausea and vomiting--a continuous quality improvement initiative.  Can J Anaesth. 2004;  51 320-325
    CrossrefGoogle Scholar
  • 117 van den Bosch J E, Kalkman C J, Vergouwe Y et al.. Assessing the applicability of scoring systems for predicting postoperative nausea and vomiting.  Anaesthesia. 2005;  60 323-331
    CrossrefGoogle Scholar
  • 118 Engel J M, Junger A, Hartmann B et al.. Performance and customization of 4 prognostic models for postoperative onset of nausea and vomiting in ear, nose, and throat surgery.  J Clin Anesth. 2006;  18 256-263
    CrossrefGoogle Scholar
  • 119 Kooij F O, Klok T, Hollmann M W et al.. Decision support increases guideline adherence for prescribing postoperative nausea and vomiting prophylaxis.  Anesth Analg. 2008;  106 893-898
    CrossrefPubMedGoogle Scholar
  • 120 Kranke P, Schuster F, Eberhart L H et al.. Recent advances, trends and economic considerations in the risk assessment, prevention and treatment of postoperative nausea and vomiting.  Expert Opin Pharmacother . 2007;  8 3217-3235
    CrossrefGoogle Scholar

Prof. Dr. Leopold H. J. Eberhart
Dr. Dirk Rüsch

Philipps-Universität Marburg

Klinik für Anästhesie und Intensivtherapie

Baldingerstraße

35033 Marburg

Phone: 06421-58-62945

Fax: 06421-58-65898

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