The Management of Postoperative Nausea and Vomiting: Current Thoughts and Protocols
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The postoperative course of surgical patients can have a tremendous impact on the surgical outcome and on patient satisfaction. One of the most significant issues is postoperative nausea and vomiting (PONV) which, despite being a common side effect of general anesthesia, has received little attention in the plastic surgery literature. The incidence and potential consequences of PONV are frequently underestimated and consequently the need for prophylaxis is often overlooked. There are significant consequences to this seemingly minor morbidity that extend beyond patient discomfort and dissatisfaction. In addition to being considered a significant undesirable outcome by patients, severe cases of PONV may result in postoperative complications and unplanned hospital admissions. In this article we overview the mechanism, pathophysiology, and risk factors for PONV and provide a comprehensive algorithmic approach to its management.
Level of Evidence V
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KeywordsPostoperative nausea and vomiting Etiology of postoperative nausea and vomiting Treatment of postoperative nausea and vomiting
Conflict of interest
The authors have no conflicts of interest to disclose.
- 6.Basdag B, Shridharani SM, Gilson MM, Jacobs LK, Magarakis M, Rosson GD (2010) The incidence of postoperative nausea and vomiting in patients undergoing deep inferior epigastric artery perforator flap breast reconstruction: highlighting an unmet need. Plast Reconstr Surg 125(6):142Google Scholar
- 31.Jeneby TT, Thakur A, Rosen HM (2006) The use of intravenous dexamethasone for preventing postoperative nausea or vomiting in the cosmetic plastic surgical patient: analysis of 70 consecutive patients. Plast Reconstr Surg 118(4):166–172Google Scholar
- 41.McCarthy BG, Peroutka SJ (1998) Differentiation of muscarinic cholinergic receptor subtypes in human cortex and pons: implications for anti-motion sickness therapy. Aviat Space Environ Med 59(1):63–71Google Scholar
- 47.Philip BK (1997) Etiologies of postoperative nausea and vomiting. Pharmacy Ther 22:18–25Google Scholar
- 55.Sweis I, Yegiyants S, Cohen MN (2011) The management of postoperative nausea and vomiting. Plastic surgery hyperguide. Available at www.plasticsurgery.hyperguides.com/activity.aspx?aid=76868. Accessed 12 May 2012
- 58.Vinicius M, Barbosa J, Nahas FX, Ferreira LM, Farah AB, Bariani RL (2004) Ondansetron for the prevention of postoperative nausea and vomiting: which is the best dosage for aesthetic plastic surgery? Aesthet Plast Surg 28(1):33–36Google Scholar