Perioperative nausea and vomiting

Perioperative Nausea and Vomiting

Perioperative nausea and vomiting (PONV) is a common complication among patients receiving anesthesia, causing distress and discomfort. PONV can lead to prolonged hospital stays, delayed recovery from surgery, and an increased risk of postoperative complications. Fortunately, there are several preventive strategies that practitioners can use to reduce the likelihood of this phenomenon.

Causes of Perioperative Nausea and Vomiting

PONV is mainly caused by drug effects and factors related to the patient, the surgical procedure, and the care that is provided during and after anesthesia. Common drugs associated with PONV include opioids, benzodiazepines, inhalational anesthetics, and anticholinergics. Factors related to the patient include gender, smoking, and the patient’s history of PONV. Additionally, general anesthesia, abdominal surgery, and a long duration of anesthesia increase the risk of PONV.

Preventive Strategies

To reduce the risk of PONV, there are several preventive strategies that can be employed. These include:

1. Administering antiemetic medications before the start of surgery
2. Administering lower concentrations of inhalational anesthetics
3. Using opioid-sparing techniques and regional anesthetics and analgesics
4. Using prophylactic corticosteroids and ginger prior to surgery
5. Improving postoperative pain control

In addition, practitioners should be aware of risk factors for PONV and tailor their anesthesia plan to each individual patient. They should also be alert for the development of PONV symptoms during surgery and provide prompt treatment for those who experience it.