日本人における股関節全置換術後の悪心・嘔吐に対するオンダンセトロンの予防的効果の検討

The Effectiveness of Ondansetron for Preventing Postoperative Nausea and Vomiting after Total Hip Arthroplasty（THA） in Japanese

要旨

　海外において術後悪心・嘔吐（postoperative nausea and vomiting：PONV）に標準的に使用されてきたオンダンセトロンが2021年8月よりわが国で保険適用となった。そこでオンダンセトロンのPONVに対する有効性を後ろ向きに検討した。海外の報告同様，オンダンセトロンは術後24時間，特に術後6時間までのPONVと術後嘔吐（POV）に対してより有効である可能性が示唆された。

　Background：Ondansetron is commonly used and is considered the “gold standard” in the management of postoperative nausea and vomiting（PONV）, but ondansetron was not approved for use for PONV in Japan until 2021. This study was an evaluation of the efficacy of ondansetron for preventing PONV in Japanese patients.

　Methods：We conducted a single-site retrospective analysis of patients who had been treated with THA in 2022. The incidences of PONV and postoperative vomiting（POV）for the 6-hr and 24-hr periods beginning at the surgery’s completion were measured.

　Results：Of the 159 Japanese patients examined（19 males, 140 females, mean±SD age 62.8±8.19 years）, 60 patients received ondansetron and the other 99 patients did not. During the 6-hr and 24-hr postoperative periods, the respective incidences of PONV in the ondansetron group were 8％ and 30％, and those of POV were 0％ and 10％, and each of these values were lower than the corresponding values in the non-ondansetron group.

　Conclusions：Ondansetron was observed to be as effective for PONV and POV in Japanese patients as it has been for other populations, and it was particularly useful in the early postoperative period.