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術後の痛みと吐き気に対する術後のニコチン:臨床的および方法論的洞察による体系的レビュー
Feras Twfeq Almogbel1, Mohammed Ali Alghamdi2, Ali Mohamed Elkarouri3
1Dammam Medical Complex, Nephrology Clinical Pharmacy Consultant, Dammam, Saudi Arabia.
Anesthesiology and pain medicine
|February 20, 2026
まとめ
術後のニコチンは,術後の痛みやオピオイド使用を軽減する可能性があるが,術後の吐き気および嘔吐 (PONV) に対する効果は一貫していない. ニコチンを明確にするためにさらなる研究が必要である.
科学分野:
- アネステシオロジーと外科手術後の医療
- 薬理学 薬理学とは
- 疼痛管理 疼痛管理
背景:
- ニコチンの潜在的鎮痛効果と嘔吐抑制効果は認められている.
- 手術後の痛みと吐き気 (PONV) に対するニコチンに関する以前の研究は,矛盾した結果をもたらしました.
- 術後のニコチンの影響に関する包括的なレビューの必要性は明らかです.
研究 の 目的:
- 術後の疼痛管理のための術後のニコチン投与に関する証拠を体系的にレビューし,合成する.
- 術後の吐き気と嘔吐 (PONV) に対する手術前ニコチンの効果を評価する.
- 術後期におけるオピオイド摂取に対するニコチンの影響を評価する.
主な方法:
- PubMed,CENTRAL,およびGoogle Scholar (2004-2023) の体系的な文献検索を行いました.
- PICO基準:全身麻酔下にある患者,手術前ニコチン介入,プラセボ/ニコチンのないコントロール,疼痛スコア,プライマリアウトカム.
- コクランリスク・オブ・バイアス2ツールを用いた11の研究 (753人の参加者) の発見のナラティブ・シンセシス.
主要な成果:
- 753人の参加者を対象とした11の研究が含まれており,手術手順,ニコチンの投与方法,投与量は様々でした.
- 術後のニコチン投与は,いくつかの研究で,術後の痛み,吐き気,嘔吐,オピオイド摂取の潜在的減少を示しました.
- 研究間の有意な異質性は,さらなるサブグループ分析を妨げました.
結論:
- 術後のニコチンは,術後の疼痛管理を改善し,オピオイドの必要性を減らすために有望であることが示されています.
- 術後の吐き気および嘔吐 (PONV) に対するニコチンの影響は一貫性がないままであり,慎重に検討する必要があります.
- 研究集団,ニコチン用量,および配方における変動性は,最終的な臨床勧告を制限する.
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