Prophylaxis against postoperative nausea and vomiting

Prophylaxis against Postoperative Nausea and Vomiting

Postoperative nausea and vomiting (PONV) is a very common problem for patients who have undergone any type of surgical procedure. It is estimated that up to 25-30% of patients experience some form of PONV after surgery. Prophylactic treatment of PONV involves the use of medications, such as antiemetics, that are taken prior to the patient receiving anesthesia in order to reduce the likelihood of PONV once the patient wakes up from the procedure.

There are a variety of antiemetics that are available to help reduce the risk of PONV for patients. The most commonly used antiemetics include:

• Serotonin receptor antagonists (ondansetron, granisetron, dolasetron, palonosetron)
• Dopamine antagonists (prochlorperazine, metoclopramide, droperidol)
• NK1 antagonists (aprepitant, fosaprepitant)
• Muscarinic antagonists (scopolamine)

These medications have all been proven to reduce the risk of PONV in patients following surgical procedures. The choice of which medication is best depends on the type of surgery, the patient’s medical history, and any other medications they are taking or have taken in the past. Some medications may be more effective in certain people and less effective in others.

In addition to medication, other methods of prophylaxis against PONV include the administration of oxygen to the patient during the induction and emergence phases of surgery, keeping the operating room temperature cool, avoiding triggers such as unpleasant odors, using regional anesthesia instead of general anesthesia, and delaying the resumption of feeding until at least two hours after the completion of surgery.

Prophylactic treatment of PONV is an important way to reduce the likelihood of experiencing postoperative nausea and vomiting. Patients should consult with their doctor to determine the best method of prophylaxis for their surgical procedure.