Preventing opioid-induced nausea and vomiting: Rest your head and close your eyes?
Although opioid-induced nausea and vomiting (OINV) is common and debilitating, its mechanism is still unclear. Recently, we suggested that opioids affect semicircular canal function and that this leads to a mismatch between canal input and other sensory information during head motion, which triggers...
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doaj-44eecc236cb24888a42f484528469a692020-11-25T01:20:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01123e017392510.1371/journal.pone.0173925Preventing opioid-induced nausea and vomiting: Rest your head and close your eyes?Fabian HeuserChristian SchulzMurat SağlamCecilia RamaioliMaria HeubergerKlaus J WagnerKlaus JahnErich SchneiderThomas BrandtStefan GlasauerNadine LehnenAlthough opioid-induced nausea and vomiting (OINV) is common and debilitating, its mechanism is still unclear. Recently, we suggested that opioids affect semicircular canal function and that this leads to a mismatch between canal input and other sensory information during head motion, which triggers OINV. Here, we assess if visual input is relevant for this mismatch. In a randomized-controlled crossover study 14 healthy men (26.9±3.4 years, mean±SD) were tested twice, once blindfolded and once with eyes open, with at least one-day washout. The opioid remifentanil was administered intravenously (0.15 μg/kg/min) for 60 minutes. After a thirty-minutes resting period, subjects' head and trunk were passively moved. Nausea was rated before remifentanil start (T0), before the movement intervention (T30) and after 60 minutes (T60) of administration. At rest (T0, T30), median nausea ratings were zero whether subjects were blindfolded or not. Movement triggered nausea independently of visual input (nausea rating 1.5/3.0 (median/interquartile range) in the blindfolded, 2.5/6 in the eyes-open condition, χ2(1) = 1.3, p = 0.25). As movement exacerbates OINV independently of visual input, a clash between visual and semicircular canal information is not the relevant trigger for OINV. To prevent OINV, emphasis should be put on head-rest, eye-closure is less important.http://europepmc.org/articles/PMC5349672?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fabian Heuser Christian Schulz Murat Sağlam Cecilia Ramaioli Maria Heuberger Klaus J Wagner Klaus Jahn Erich Schneider Thomas Brandt Stefan Glasauer Nadine Lehnen |
spellingShingle |
Fabian Heuser Christian Schulz Murat Sağlam Cecilia Ramaioli Maria Heuberger Klaus J Wagner Klaus Jahn Erich Schneider Thomas Brandt Stefan Glasauer Nadine Lehnen Preventing opioid-induced nausea and vomiting: Rest your head and close your eyes? PLoS ONE |
author_facet |
Fabian Heuser Christian Schulz Murat Sağlam Cecilia Ramaioli Maria Heuberger Klaus J Wagner Klaus Jahn Erich Schneider Thomas Brandt Stefan Glasauer Nadine Lehnen |
author_sort |
Fabian Heuser |
title |
Preventing opioid-induced nausea and vomiting: Rest your head and close your eyes? |
title_short |
Preventing opioid-induced nausea and vomiting: Rest your head and close your eyes? |
title_full |
Preventing opioid-induced nausea and vomiting: Rest your head and close your eyes? |
title_fullStr |
Preventing opioid-induced nausea and vomiting: Rest your head and close your eyes? |
title_full_unstemmed |
Preventing opioid-induced nausea and vomiting: Rest your head and close your eyes? |
title_sort |
preventing opioid-induced nausea and vomiting: rest your head and close your eyes? |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2017-01-01 |
description |
Although opioid-induced nausea and vomiting (OINV) is common and debilitating, its mechanism is still unclear. Recently, we suggested that opioids affect semicircular canal function and that this leads to a mismatch between canal input and other sensory information during head motion, which triggers OINV. Here, we assess if visual input is relevant for this mismatch. In a randomized-controlled crossover study 14 healthy men (26.9±3.4 years, mean±SD) were tested twice, once blindfolded and once with eyes open, with at least one-day washout. The opioid remifentanil was administered intravenously (0.15 μg/kg/min) for 60 minutes. After a thirty-minutes resting period, subjects' head and trunk were passively moved. Nausea was rated before remifentanil start (T0), before the movement intervention (T30) and after 60 minutes (T60) of administration. At rest (T0, T30), median nausea ratings were zero whether subjects were blindfolded or not. Movement triggered nausea independently of visual input (nausea rating 1.5/3.0 (median/interquartile range) in the blindfolded, 2.5/6 in the eyes-open condition, χ2(1) = 1.3, p = 0.25). As movement exacerbates OINV independently of visual input, a clash between visual and semicircular canal information is not the relevant trigger for OINV. To prevent OINV, emphasis should be put on head-rest, eye-closure is less important. |
url |
http://europepmc.org/articles/PMC5349672?pdf=render |
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