Post-Operative Nausea and Vomiting


Reviews on Postoperative Nausea and Vomiting

PONV is an unwelcome problem in the peri-operative period.

Effective drug treatment requires a planned management protocol that includes intravenous anti-emetic administration at appropriate time intervals (ie, if a specific agent hasn’t worked by the time it should have, give something else!). Drugs included in a PONV protocol should span the range of pathways involved. Medical review is needed for any patient with refractory PONV to exclude a surgical or medical cause.

When reviewing abstracts, note the difference between prophylaxis and treatment protocols, and also between nausea and vomiting. Hospitals should have a prophylaxis protocol that identifies at-risk groups and the agent/s they should be offered, and independently a treatment protocol for nurses to use in the peri-operative period for anyone afflicted with PONV.

Annalyn Kuok provides this point-form summary of PONV and its management.

PONV is discussed in detail by Gan in 2003, Chatterjee, Etherweb, Anaesthesia UK,

Paul White discussess 5-HT3 antagonists in the ambulatory setting.

If you’re registered, this MedScape article is good.

Drug Monographs

Monographs for most anti-emetics can readily be obtained via the US NLM DailyMed, NZ Govt MedSafe or RxMed sites.

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