Perspectives on transdermal scopolamine for the treatment of postoperative nausea and vomiting

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• 作者：Joseph V. Pergolizzi Jr. ; MD^a ; ^b ; ^c ; ^{jpjmd@msn.com} (Adjunct Assistant Professor) ; Beverly K. Philip ; MD^d ; ^e (Professor) ; John B. Leslie ; MD ; MBA^f ; ^g (Professor) ; Robert Taylor Jr. ; PhD^h (Senior Fellow) ; Robert B. Raffa ; PhDⁱ (Professor)
• 关键词：Antiemetics ; Postdischarge nausea and vomiting ; Postoperative nausea and vomiting ; Transdermal scopolamine
• 刊名：Journal of Clinical Anesthesia
• 出版年：2012
• 期刊代码：147_09528180
• 类别：med
• 出版时间：June, 2012
• 卷：24
• 期：4
• 页码：334-345
• 文件大小：461 K

摘要

Transdermal scopolamine, a patch system that delivers 1.5 mg of scopolamine gradually over 72 hours following an initial bolus, was approved in the United States in 2001 for the prevention of postoperative nausea and vomiting (PONV) in adults. Scopolamine (hyoscine) is a selective competitive anatagonist of muscarinic cholinergic receptors. Low serum concentrations of scopolamine produce an antiemetic effect. Transdermal scopolamine is effective in preventing PONV versus placebo [relative risk (RR)=0.77, 95%confidence interval (CI), 0.61-0.98, P = 0.03] and a significantly reduced risk for postoperative nausea (RR=0.59, 95%CI, 0.48-0.73, P < 0.001), postoperative vomiting (RR=0.68, 95%CI, 0.61-0.76, P < 0.001), and PONV (RR 0.73, 95%CI, 0.60-0.88, P = 001) in the first 24 hours after the start of anesthesia.