Establishment of a new method of risk assessment and individual management for the prevention of postoperative nausea and vomiting

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K15514
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Medical pharmacy
• Research Institution: Gifu Pharmaceutical University
• Principal Investigator: Soda Midori 岐阜薬科大学, 薬学部, 講師 (30592604)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 術後悪心嘔吐 / オピオイド鎮痛薬 / 発症予測 / スコア評価

Outline of Final Research Achievements

Postoperative nausea and vomiting (PONV) result in poor prognosis and quality of life. The prevention of PONV is essential; however, factors inducing PONV, and the related underlying mechanism remain unknown. This study aimed to evaluate the risk factors for PONV and propose preventive strategies based on prediction. We investigated the relationships among the occurrence of PONV, concentrations of administered opioids, polymorphisms of genes involved in pharmacokinetics and pharmacodynamics, and the known risk factors for PONV. In addition to the known factors, response to preoperative opioids and the polymorphism of the mu-opioid receptor gene were found to be related with the occurrence of PONV. The risk assessment based on these newly identified factors had a comparable predictive accuracy as the already established assessment. These results suggest that this new risk assessment can be used to predict the occurrence of PONV and therefore, initiate early preventive treatment of PONV.

Free Research Field

医療薬学

Academic Significance and Societal Importance of the Research Achievements

PONVは術後患者の3分の1が経験する愁訴であり、予後の悪化やQOLの低下を招く。その発症は、性別や喫煙歴など患者の背景因子に基づいてリスク評価されているが、薬効、薬物動態や薬物に対する反応性等に関連する因子との関連はあまり解明されていない。本研究では、薬物に対する反応性と感受性に関連する遺伝子多型がPONVの発症と関連することを見出した。これらの因子を用いたリスク評価は、患者背景因子を用いた既存のリスク評価とほぼ同等の予測精度を有し、臨床現場でも応用可能と考えられ、今後の臨床応用が期待される。