scholarly journals Current Concepts in the Management of Postoperative Nausea and Vomiting

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
S. Chatterjee ◽  
A. Rudra ◽  
S. Sengupta
Keyword(s):  
Risk Factors ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Baseline Risk ◽  
Multimodal Approach ◽  
Careful Assessment

Postoperative nausea and vomiting (PONV) are still common following surgery. This is not only distressing to the patient, but increases costs. The thorough understanding of the mechanism of nausea and vomiting and a careful assessment of risk factors provide a rationale for appropriate management of PONV. Strategy to reduce baseline risk and the adoption of a multimodal approach will most likely ensure success in the management of PONV.

Prevention of Postoperative Nausea and Vomiting

2018 ◽  
pp. 147-152
Keyword(s):  
Risk Factors ◽  
Nitrous Oxide ◽  
Relative Risk ◽  
Adverse Events ◽  
Postoperative Nausea ◽  
Volatile Anesthetic ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Baseline Risk ◽  
Maximum Reduction

This case focuses on the prevention of postoperative nausea and vomiting (PONV) by asking the question: What is the efficacy of six well-established prophylactic antiemetic strategies individually and in combination for the prevention of postoperative nausea and vomiting? Each of the three antiemetics in this study (ondansetron, dexamethasone, and droperidol) reduced the risk for PONV by approximately 26%; substituting propofol for volatile anesthetic reduced the risk by 19%; and substituting nitrogen (air) for nitrous oxide reduced the risk by 12%. A maximum reduction of 70% in the relative risk for PONV can be expected when total intravenous anesthesia is used with three antiemetics. The appropriate approach to the management of PONV depends on the patient’s baseline risk factors as well as the likelihood of adverse events and costs from the antiemetic medications.

Nitrous Oxide Makes Me Sick: Or Does It? (Nitrous Oxide and Postoperative Nausea and Vomiting)

2010 ◽  
Vol 20 (6) ◽  
pp. 215-218
Author(s):  
Luke Ewart
Keyword(s):  
Nitrous Oxide ◽  
Postoperative Nausea ◽  
Clinical Management ◽  
Management Strategy ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Surgical Patients ◽  
Baseline Risk ◽  
Multimodal Approach ◽  
Strength Of Evidence

This article evaluates whether avoidance of nitrous oxide in general anaesthesia can improve clinical outcomes in surgical patients by reducing postoperative nausea and vomiting, and whether avoidance should become part of a routine clinical management strategy. Despite some controversy, the greatest strength of evidence suggests that avoidance of nitrous oxide may be justified as a pre-emptive perioperative strategy as part of a multimodal approach to postoperative nausea and vomiting, especially in those patients known to have a higher baseline risk.

Risk factors for postoperative nausea and vomiting in ophthalmological surgery

2010 ◽  
Vol 27 ◽  
pp. 28-29
Author(s):  
R. Poeira ◽  
I. Antunes ◽  
H. Filipe ◽  
A. Fernandes ◽  
F. Matos
Keyword(s):  
Risk Factors ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting

Postoperative Nausea and Vomiting Following Craniotomy: Risk Factors and Complications in Context of Perioperative High-dose Dexamethasone Application

2019 ◽  
Vol 80 (05) ◽  
pp. 381-386
Author(s):  
Till Burkhardt ◽  
Patrick Czorlich ◽  
Klaus Christian Mende ◽  
Annika Treitz ◽  
Rainer Kiefmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Postoperative Nausea ◽  
Significant Risk ◽  
Postoperative Nausea And Vomiting ◽  
Significant Risk Factor ◽  
Nausea And Vomiting ◽  
High Dose ◽  
High Dose Dexamethasone ◽  
Csf Leaks

Introduction Postoperative nausea and vomiting (PONV) is common in patients after craniotomy and may lead to severe postoperative complications. The aim of this study was to identify risk factors and postoperative complications associated with PONV in the context of perioperative high-dose dexamethasone administration. Patients and Methods In this prospective single-center study, all patients planned for elective craniotomy for supra- and infratentorial lesions were eligible to be included. Any PONV in a 24-hour period after craniotomy was recorded and analyzed with regard to time to postoperative complications and the administration of perioperatively administered high-dose dexamethasone. Results The overall PONV rate of 421 patients during a 9-month period was 18.1% (76 patients). Multivariate analysis revealed a significant association of PONV with female sex, infratentorial localization, age, and history of PONV. There was no association between PONV and postoperative complications such as intracranial hemorrhage, cerebrospinal fluid (CSF) leaks, or pneumonia. Perioperative administration of high-dose dexamethasone for prophylactic prevention of edema was the only significant risk factor for postoperative complications (odds ratio [OR]: 3.34; confidence interval [CI], 1.39–8.05; p < 0.01) with a highly significant association with the occurrence of CSF leaks (OR: 6.85; CI, 1.62–29.05; p < 0.01). Conclusion The low PONV rate of 18.1% in this study may be the result of the frequent perioperative administration of high-dose dexamethasone for the prevention of edema. Our data indicate that perioperative high-dose dexamethasone is significantly associated with CSF leaks and can therefore not be recommended on a regular basis.

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