摘要术后恶心呕吐（postoperative nausea and vomiting，PONV）是手术麻醉后常见的并发症，发生率约为30％，如不预防，高危人群的PONV发生率高达80％。虽然PONV不是最严重的术后并发症，但其对患者生活质量的影响和医疗资源的浪费不容忽视。临床研究显示，PONV的主要诱因是吸入麻醉药和阿片类药物的使用，
1APFEL C C, LRA E, KOIVURANTA M, et al. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers[J]. Anesthesiology, 1999, 91(3): 693-700.
2FERN.hNDEZ-GUISASOLA J, GOMEZ-ARNAU J I, CABRERA Y, et al. Association between nitrous oxide and the incidence of postoperative nausea and vomiting in adults:a systematic review and meta-analysis [J]. Anaesthesia, 2010, 65(4): 379-387.
3BHANDARI P, BINGHAM S, ANDREWS P L. The neuropharmacology of loperamide-induced emesis in the ferret: the role of the area postrema, vagus, opiate and 5- HT3 receptors[J]. Neuropharmacology, 1992, 31(.8): 735- 742.
4DE WINTER B Y, VAN DEN WIJNGAARD R M, DE JONGE W J. Intestinal mast cells in gut inflammation and motility disturbances[J].Biochim Biophys Acta, 2012, 1822(1) : 66-73.
5RYCHTER J, CLAVI P. Intestinal inflammation in postoperative ileus: pathogenesis and therapeutic targets [J]. Gut, 2013, 62(11): 1534-1535.
6SINCLAIR D R, CHUNG F, MEZEI G. Can postoperative nausea and vomiting be predicted? [J]. Anesthesiology, 1999, 91(1): 109-118.
7APFEL C C, HEIDRICH F M, JUKAR-RAO S, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting[J]. Br J Anaesth, 2012, 109(5) : 742- 753.
8HORNBY P J. Central neurocircuitry associated with emesis [J]. AmJ Med, 2001, 111 (Suppl 8A): 106S-112S.
9NAPADOW V, SHEEHAN J D, KIM J, et al. The brain circuitry underlying the temporal evolution of nausea in humans[J]. Cereb Cortex, 2013, 23(4): 806-813.
10JOHNSTON K D. The potential for mu-opioid receptor agonists to be anti-emetic in humans: a review of clinical data[J]. Acta Anaesthesiol Scand, 2010, 54(2): 132-140.
