Pharmacology
The introduction of the 5HT3 receptor antagonist, ondansetron, in the early 1990s was a significant breakthrough. Despite the many studies, however, the evidence base to support rational antiemetic treatment remains patchy. Recent research has led to better understanding of some older drugs and has demonstrated that combinations of drugs are often useful. While the efficacy of droperidol is now clear, metoclopramide, a popular antiemetic for decades, was found to have limited efficacy at the lower traditional dosage. Some older drugs, such as haloperidol and hyoscine remain inadequately studied.
Emetogenic drugs commonly used in anaesthesia include nitrous oxide, physostigmine and opioids. The intravenous anaesthetic propofol is currently the least emetogenic general anaesthetic.
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