Association between increased 5-HIAA plasma concentrations and postoperative nausea and vomiting in patients undergoing general anaesthesia for surgery

Läer, Stephanie; Scholz, Jens; Ritterbach, C.; Laer, Christine Van; Rahme, Elham; Esch, Jochen Schulte am

doi:10.1097/00003643-200112000-00009

Cited by 11 publications

(5 citation statements)

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“…5-HT3 receptor-mediated currents are enhanced by isoflurane but depressed by sevoflurane. Alternatively, enhancement of serotonin levels may be involved [133]. The observation that PONV is less frequently observed with propofol [128,129,134] strongly suggests that this side effect is associated with a molecular target of volatile anaesthetic agents which is less sensitive to propofol.…”

Section: Undesired Side Effectsmentioning

confidence: 99%

Anaesthetic Drugs: Linking Molecular Actions to Clinical Effects

Grasshoff¹,

Drexler²,

Rudolph³

et al. 2006

CPD

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The use of general anaesthetics has facilitated great advantages in surgery within the last 150 years. General anaesthesia is composed of several components including analgesia, amnesia, hypnosis and immobility. To achieve these components, general anaesthetics have to act via multiple molecular targets at different anatomical sites in the central nervous system. Much of our current understanding of how anaesthetics work has been obtained within the last few years on the basis of genetic approaches, in particular knock-out or knock-in mice. Anaesthetic drugs can be grouped into volatile and intravenous anaesthetics according to their route of administration. Common volatile anaesthetics induce immobility via molecular targets in the spinal cord, including glycine receptors, GABA(A) receptors, glutamate receptors, and TREK-1 potassium channels. In contrast, intravenous anaesthetics cause immobility almost exclusively via GABA(A) receptors harbouring beta3 subunits. Hypnosis is predominantly mediated by beta3-subunit containing GABA(A) receptors in the brain, whereas beta2 subunit containing receptors, which make up more than 50% of all GABA(A) receptors in the central nervous system, mediate sedation. At clinically relevant concentrations, ketamine and nitrous oxide block NMDA receptors. Unlike all other anaesthetics in clinical use they produce analgesia. Not only desired actions of anaesthetics, but also undesired side effects are linked to certain receptors. Respiratory depression involves beta3 containing GABA(A) receptors whereas hypothermia is largely mediated by GABA(A) receptors containing beta2 subunits. These recent insights into the clinically desired and undesired actions of anaesthetic agents provide new avenues for the design of drugs with an improved side-effect profile. Such agents would be especially beneficial for the treatment of newborn children, elderly patients and patients undergoing ambulatory surgery.

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Section: Undesired Side Effectsmentioning

confidence: 99%

Anaesthetic Drugs: Linking Molecular Actions to Clinical Effects

Grasshoff¹,

Drexler²,

Rudolph³

et al. 2006

CPD

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“…Ferner wurde mit der multiplen logistischen Regressionsanalyse gezeigt, dass ein Anstieg der 5-HIES-PlasmaKonzentration ein unabhängiger Risikofaktor für die Entwicklung von "postoperative nausea and vomiting" (PONV) darstellt [11].…”

Section: Vergleichende Darstellung Der 5-hies-konzentrationen Im Urinunclassified

“…Die von uns erzielten Resultate bestätigen somit z. T. auch die zuvor von Läer et al publizierten Daten; danach besteht ein Zusammenhang zwischen dem Auftreten von Ü&E und dem Anstieg der 5-HIES-Plasma-Konzentrationen [11]. Interessanterweise deuten die von uns erzielten Ergebnisse jedoch nicht darauf hin,dass auch ein Zusammenhang zwischen dem Auftreten von Ü und vermehrter Ausscheidung von 5-HIES vorliegt, wie dies von Läer et al berichtet wurde.…”

Section: Vergleichende Darstellung Der 5-hies-konzentrationen Im Urinunclassified

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Erbrechen nach gyn�kologischen Laparoskopien in Allgemeinan�sthesie ist assoziiert mit Ver�nderungen der Serotoninmetabolitenausscheidung

Rüsch¹,

Straßer

Çelik³

et al. 2004

Der Anaesthesist

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“…This suggested that serotonin-release secondary to the subtle intestinal hypoxia or ischemia associated with abdominal surgery is an unlikely mechanism for PONV. Further, one would expect the emetogenicity of serotonin to correspond with peak levels of serotonin, which occurs intraoperatively rather than postoperatively; and due to its short half-life of only a few minutes, that serotonin would contribute little to the development of a postoperative phenomenon [18]. Of note, nausea and vomiting are not part of the classic "carcinoid triad" associated with serotoninsecreting tumors.…”

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confidence: 99%