脳神経外科領域におけるmetoclopramideの使用経験

THE USE OF METOCLOPRAMIDE･HCI IN NEUROSURGERY

　I．はじめに　脳神経外科領域においては悪心，嘔吐になやまされることが少なくない。脳腫瘍，頭部外傷，脳血管障害などは脳神経外科における重要な，そして数も多い疾患であるが，これらの大多数の症例はその経過中にいくどかは悪心，嘔吐を経験している。悪心，嘔吐がまつたくないという例はむしろめずらしい。

　これらの治療にあたつては原疾患に対する根治的療法を行なうべきはいうまでもないことであるが，その治療の過程において，すなわち手術後の数日間において，あるいは悪性腫瘍に対する放射線療法または化学療法の過程において，あるいは種々の検査，とくに気脳撮影に際して一時的ではあるが，強い悪心，嘔吐が頻発することがある。そのため強力な制吐剤の出現が望まれるのである。幸い日本メルク万有株式会社より新しい制吐剤meto—clopramide hydrochlorideの試供品を得，種々の症例に試用する機会を得たのでこの結果について報告する。

(1) A new antiemetic drug, by the name of Meto-clopramide was administered on 21 neurosurgical cases with complaints of nausea or vomiting. And our results were as follows : (i) post-operative nausea or vomiting was comple-tely controlled and satisfactory rest could be main-tained continuously. (ii) Severe and frequent nausea and vomiting which occurred during radiation therapy in some cases of pontine tumors and 4th ventricle tumors were satisfactorily controlled. (iii) Severe vomiting which occured during chemo-therapy (intracarotid continuous infusion) on pa-tients of glioblastoma or metastatic brain tumors were not completely but fairly well controlled. (iv) Vomiting as a result of acute head injury was completely controlled.

(2) On 9 cases, metoclopramide was used either before or after the procedure of pneumoencephalo-graphy. Effective results were obtained on 3 cases with severe vomiting after pneumoencephalography. On 6 cases, the drug was used as premedication and excellent antiemetic effects were obtained on all cases with the exception of one case.