title: Is there an association between PONV and chemotherapy-induced nausea and vomiting?
abstract: BACKGROUND
  Drug-induced nausea and vomiting, both post-operatively and following chemotherapy, is often distressing for the patients. Our clinical impression is that certain patients are not prone to but instead protected against both post-operative and chemotherapy-induced nausea and vomiting (CINV). If support for this hypothesis could be generated, it might be easier to identify such patients as low-risk patients and judge all other patients as high-risk patients by default.
  
  
  METHODS
  All patients scheduled for breast cancer surgery at Danderyd Hospital, Stockholm, Sweden during 1 year (March 2003-March 2004) were asked to participate in this prospective, observational study. A number of women went on to receive adjuvant chemotherapy. Post-operatively, patients were assessed for 24 h with regard to the occurrence of post-operative nausea and vomiting (PONV). CINV was assessed for 5 days after start of chemotherapy.
  
  
  RESULTS
  A total of 275 women were included, 33% were classified as PONV and 67% as non-PONV. Sixty-one of the 275 women included were later subjected to adjuvant chemotherapy. In the non-PONV group, 95% of the patients did not experience CINV, whereas the association between PONV and subsequent CINV was only 38%.
  
  
  CONCLUSIONS
  A substantially stronger interrelationship was found between non-PONV and non-CINV than between both PONV and CINV. This may suggest that certain patients, instead of being prone to nausea and vomiting, in fact in some way are protected against these unpleasant side effects.
authors.affiliation: Division of Anaesthesia and Intensive Care, Danderyd Hospital, Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Oddby-Muhrbeck
authors.forename: E
authors.initials: E
authors.lastname: Öbrink
authors.forename: S
authors.initials: S
authors.lastname: Eksborg
authors.forename: S
authors.initials: S
authors.lastname: Rotstein
authors.forename: P A
authors.initials: PA
authors.lastname: Lönnqvist
mesh_terms: D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001623:Betamethasone / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D060467:Disease Resistance; D004329:Droperidol / Q000627:therapeutic use; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D017829:Granisetron / Q000627:therapeutic use; D006801:Humans; D008408:Mastectomy; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008787:Metoclopramide / Q000627:therapeutic use; D008875:Middle Aged; D008954:Models, Biological; D009294:Narcotics / Q000009:adverse effects; D009325:Nausea / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D017294:Ondansetron / Q000627:therapeutic use; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000503:physiopathology* / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D014839:Vomiting / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D001623:Betamethasone; D003520:Cyclophosphamide; D004329:Droperidol; D015251:Epirubicin; D005472:Fluorouracil; D017829:Granisetron; D008727:Methotrexate; D008787:Metoclopramide; D009294:Narcotics; D017294:Ondansetron