[Postoperative nausea and vomiting--what's new in anti-emetic pharmacotherapy?]

Abstract

Neurokinin-1 receptor antagonists represent a new approach in the prevention of postoperative nausea and vomiting (PONV) and show an efficacy comparable with those of common antiemetics with some evidence for superiority with regard to vomiting. Currently, only aprepitant is available as an oral preparation. Palonosetron is a new representative of the serotonin-3 receptor antagonists but without the hoped for superiority on the 2nd and 3rd postoperative days. However, available data do suggest that palanosetron does not prolong the OT (c) interval. When using 5-HT (3)-receptor antagonists for the prevention of PONV, anaesthetists should be aware of negative interactions with analgesics. Low-dose droperidol has regained approval and should be considered as first choice among the current available neuroleptics.