Skip to main content

Advertisement

SpringerLink
Log in

An update on the management of postoperative nausea and vomiting

  • Review Article
  • Published:
Journal of Anesthesia Aims and scope Submit manuscript

Abstract

Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. PONV and PDNV can delay discharge and recovery and increase medical costs. The high incidence of PONV has persisted in part because of the tremendous growth in ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major operations. Pharmacological management of PONV should be tailored to the patients’ risk level using the PONV and PDNV scoring systems to minimize the potential for these adverse side effects in the postoperative period. A combination of prophylactic antiemetic drugs should be administered to patients with moderate-to-high risk of developing PONV in order to facilitate the recovery process. Optimal management of perioperative pain using opioid-sparing multimodal analgesic techniques and preventing PONV using prophylactic antiemetics are key elements for achieving an enhanced recovery after surgery. Strategies that include reductions of the baseline risk (e.g., adequate hydration, use of opioid-sparing analgesic techniques) as well as a multimodal antiemetic regimen will improve the likelihood of preventing both PONV and PDNV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Glass PS, White PF. Practice guidelines for the management of postoperative nausea and vomiting: past, present, and future. Anesth Analg. 2007;105(6):1528–9.

    Article  PubMed  Google Scholar 

  2. Brettner F, Janitza S, Prüll K, Weninger E, Mansmann U, Küchenhoff H, Jovanovic A, Pollwein B, Chappell D, Zwissler B, von Dossow V. Gender-specific differences in low-dose haloperidol response for prevention of postoperative nausea and vomiting: a register-based cohort study. PLoS One. 2016;11(1):e0146746.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Fero KE, Jalota L, Hornuss C, Apfel CC. Pharmacologic management of postoperative nausea and vomiting. Expert Opin Pharmacother. 2011;12:2283–96.

    Article  CAS  PubMed  Google Scholar 

  4. Kovac AL. Update on the management of postoperative nausea and vomiting. Drugs. 2013;73:1525–47.

    Article  CAS  PubMed  Google Scholar 

  5. Phillips C, Brookes CD, Rich J, Arbon J, Turvey TA. Postoperative nausea and vomiting following orthognathic surgery. Int J Oral Maxillofac Surg. 2015;44(6):745–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Jildenstal P, Oddby E, Jakobsson JG. Post-operative nausea and vomiting: update on predicting the probability and ways to minimize its occurrence, with focus on ambulatory surgery. Int J Surg. 2015;15:100–6.

    Article  PubMed  Google Scholar 

  7. White PF, O’Hara JF, Roberson CR, Wender RH, Candiotti KA, POST-OP Study Group. The impact of current antiemetic practices on patient outcomes: a prospective study on high-risk patients. Anesth Analg. 2008;107(2):452–8.

    Article  PubMed  Google Scholar 

  8. Scuderi PE, White PF. Novel therapies for postoperative nausea and vomiting: statistically significant versus clinically meaningful outcomes. Anesth Analg. 2011;112(4):750–2.

    Article  PubMed  Google Scholar 

  9. Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N, IMPACT Investigators. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 2004;350(24):2441–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. White PF, Tang J, Hamza MA, Ogunnaike B, Lo M, Wender RH, Naruse R, Sloninsky A, Kariger R, Cunneen S, Khalili T. The use of oral granisetron versus intravenous ondansetron for antiemetic prophylaxis in patients undergoing laparoscopic surgery: the effect on emetic symptoms and quality of recovery. Anesth Analg. 2006;102(5):1387–93.

    Article  CAS  PubMed  Google Scholar 

  11. Hahm TS, Ko JS, Choi SJ, Gwak MS. Comparison of the prophylactic antiemetic efficacy of ramosetron and ondansetron in patients at high-risk for postoperative nausea and vomiting after total knee replacement. Anaesthesia. 2010;65:500–4.

    Article  CAS  PubMed  Google Scholar 

  12. Joo Jin, Park Shinhye, Park HJ, Shin SY. Ramosetron versus ondansetron for postoperative nausea and vomiting in strabismus surgery patients. BMC Anesthesiol. 2016;16:41–8.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Singh PM, Borle A, Gouda D, Makkar JK, Arora MK, Trikha A, Sinha A, Goudra B. Efficacy of palonosetron in postoperative nausea and vomiting (PONV)—a meta-analysis. J Clin Anesth. 2016;34:459–82.

    Article  CAS  PubMed  Google Scholar 

  14. Tang J, Wang B, White PF, Watcha MF, Qi J, Wender RH. The effect of timing of ondansetron administration on its efficacy, cost-effectiveness, and cost-benefit as a prophylactic antiemetic in the ambulatory setting. Anesth Analg. 1998;86:274–82.

    CAS  PubMed  Google Scholar 

  15. Wang JJ, Ho ST, Lee SC, Liu YC, Ho CM. The use of dexamethasone for preventing postoperative nausea and vomiting in females undergoing thyroidectomy: a dose-ranging study. Anesth Analg. 2000;91:1404–7.

    Article  CAS  PubMed  Google Scholar 

  16. Maitra S, Som A, Baidya DK, Bhattacharjee S. Comparison of ondansetron and dexamethasone for prophylaxis of postoperative nausea and vomiting in patients undergoing laparoscopic surgeries: a meta-analysis of randomized controlled trials. Anesthesiol Res Pract. 2016;2016:7089454.

    PubMed  PubMed Central  Google Scholar 

  17. Sayed JA, Riad F, Ma M, Ali MO. Comparison of dexamethasone or intravenous fluids or combination of both on postoperative nausea, vomiting and pain in pediatric strabismus surgery. J Clin Anesth. 2016;34:136–42.

    Article  CAS  PubMed  Google Scholar 

  18. Liu M, Zhang H, Du BX, Xu FY, Zou Z, Sui B, Shi XY. Neurokinin-1 receptor antagonists in preventing postoperative nausea and vomiting: a systematic review and meta-analysis. Medicine (Baltimore). 2015;94(19):e762.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Diemunsch P, Gan TJ, Philip BK, Girao MJ, Eberhart L, Irwin MG, Pueyo J, Chelly JE, Carides AD, Reiss T, Evans JK, Lawson FC, Aprepitant-PONV Protocol 091 International Study Group. Single-dose aprepitant vs ondansetron for the prevention of postoperative nausea and vomiting: a randomized, double-blind phase III trial in patients undergoing open abdominal surgery. Br J Anaesth. 2007;99:202–11.

    Article  CAS  PubMed  Google Scholar 

  20. Milnes V, Gonzalez A, Amos V. Aprepitant: a new modality for the prevention of postoperative nausea and vomiting: an evidence-based review. J Perianesth Nurs. 2015;30(5):406–17.

    Article  PubMed  Google Scholar 

  21. Gan TJ, Apfel CC, Kovac A, Philip BK, Singla N, Minkowitz H, Habib AS, Knighton J, Carides AD, Zhang H, Horgan KJ, Evans JK, Lawson FC, Aprepitant-PONV Study Group. A randomized, double-blind comparison of the NK1 antagonist, aprepitant, versus ondansetron for the prevention of postoperative nausea and vomiting. Anesth Analg. 2007;104:1082–9.

    Article  CAS  PubMed  Google Scholar 

  22. Emami H, Hematti S, Saeidian SM, Feizi A, Taheri S, Adeli P, Mahmoudi G. The efficacy of combination of ondansetron and aprepitant on preventing the radiotherapy-induced nausea and vomiting. J Res Med Sci. 2015;20(4):329–33.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. White PF. Droperidol: a cost-effective antiemetic for over 30 years. Anesth Analg. 2002;95:789–90.

    CAS  PubMed  Google Scholar 

  24. Fortney JT, Gan TJ, Graczyk S, Wetchler B, Melson T, Khalil S, McKenzie R, Parrillo S, Glass PS, Moote C, Wermeling D, Parasuraman TV, Duncan B, Creed MR. A comparison of the efficacy, safety, and patient satisfaction of ondansetron versus droperidol as antiemetics for elective outpatient surgical procedures: S3A-409 and S3A-410 Study Groups. Anesth Analg. 1998;86:731–8.

    Article  CAS  PubMed  Google Scholar 

  25. Hill RP, Lubarsky DA, Phillips-Bute B, Fortney JT, Creed MR, Glass PS, Gan TJ. Cost-effectivenessof prophylactic antiemetic therapy with ondansetron, droperidol, or placebo. Anesthesiology. 2000;92:958–67.

    Article  CAS  PubMed  Google Scholar 

  26. White PF. Prevention of postoperative nausea and vomiting—a multimodal solution to a persistent problem. N Engl J Med. 2004;350(24):2511–2.

    Article  CAS  PubMed  Google Scholar 

  27. Tricco AC, Soobiah C, Blondal E, Veroniki AA, Khan PA, Vafaei A, Ivory J, Strifler L, Ashoor H, MacDonald H, Reynen E, Robson R, Ho J, Ng C, Antony J, Mrklas K, Hutton B, Hemmelgarn BR, Moher D, Straus SE. Comparative safety of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis. BMC Med. 2015;13:142–54.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Mishriky BM, Habib AS. Metoclopramide for nausea and vomiting prophylaxis during and after caesarean delivery: a systematic review and meta-analysis. Br J Anaesth. 2012;108(3):374–83.

    Article  CAS  PubMed  Google Scholar 

  29. White PF, Tang J, Song D, Coleman JE, Wender RH, Ogunnaike B, Sloninsky A, Kapu R, Shah M, Webb T. Transdermal scopolamine: an alternative to ondansetron and droperidol for the prevention of postoperative and postdischarge emetic symptoms. Anesth Analg. 2007;104(1):92–6.

    Article  CAS  PubMed  Google Scholar 

  30. Liang X, Zhou M, Feng JJ, Wu L, Fang SP, Ge XY, Sun HJ, Ren PC, Lv X. Efficacy of dexmedetomidine on postoperative nausea and vomiting: a meta-analysis of randomized controlled trials. Int J Clin Exp Med. 2015;8(8):12113–34.

    PubMed  PubMed Central  Google Scholar 

  31. Grant MC, Betz M, Hulse M, Zorrilla-Vaca A, Hobson D, Wick E, Wu CL. The effect of preoperative pregabalin on postoperative nausea and vomiting: a meta-analysis. Anesth Analg. 2016;123:1100–7.

    Article  CAS  PubMed  Google Scholar 

  32. White PF, Tufanogullari B, Taylor J, Klein K. Effect of pregabalin on preoperative anxiety and sedation levels: a dose-ranging study. Anesth Analg. 2009;108:1140–5.

    Article  CAS  PubMed  Google Scholar 

  33. de Souza DS, Costa AF, Chaves GV. Predisposing factors for postoperative nausea and vomiting in gynecologic tumor patients. Support Care Cancer. 2016. [Epub ahead of print].

  34. White PF, Sacan O, Nuangchamnong N, Sun T, Eng MR. The relationship between patient risk factors and early versus late postoperative emetic symptoms. Anesth Analg. 2008;107(2):459–63.

    Article  PubMed  Google Scholar 

  35. Watcha MF, White PF. Postoperative nausea and vomiting: its etiology, treatment and prevention. Anesthesiology. 1992;77:162–84.

    Article  CAS  PubMed  Google Scholar 

  36. Apfel CC, Kranke P, Katz MH, Goepfert C, Papenfuss T, Rauch S, Heineck R, Greim CA, Roewer N. Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design. Br J Anaesth. 2002;88:659–68.

    Article  CAS  PubMed  Google Scholar 

  37. Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, Watcha M, Chung F, Angus S, Apfel CC, Bergese SD, Candiotti KA, Chan MT, Davis PJ, Hooper VD, Lagoo-Deenadayalan S, Myles P, Nezat G, Philip BK, Tramèr MR, Society for Ambulatory Anesthesia. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014;118:85–113.

    Article  PubMed  Google Scholar 

  38. Prathep S, Mahattanaporn S, Wasinwong W. Target controlled infusion versus sevoflurane/desflurane anesthesia for laparoscopic cholecystectomy: comparison postoperative nausea/vomiting and extubation time. J Med Assoc Thai. 2015;98(12):1187–92.

    PubMed  Google Scholar 

  39. Tramer MR, Fuchs-Buder T. Omitting antagonism of neuromuscular block: effect on postoperative nausea and vomiting and risk of residual paralysis. A systematic review. Br J Anaesth. 1999;82:379–86.

    Article  CAS  PubMed  Google Scholar 

  40. White PF, White LM, Monk T, Jakobsson J, Raeder J, Mulroy MF, Bertini L, Torri G, Solca M, Pittoni G, Bettelli G. Perioperative care for the older outpatient undergoing ambulatory surgery. Anesth Analg. 2012;114(6):1190–215.

    Article  PubMed  Google Scholar 

  41. White PF. Pain management for the elderly in the ambulatory setting. Pain Manag. 2015;5(4):233–6.

    Article  PubMed  Google Scholar 

  42. Li CC, Chen SS, Huang CH, Chien KL, Yang HJ, Fan SZ, Leighton BL, Chen LK. Fentanyl-induced cough is a risk factor for postoperative nausea and vomiting. Br J Anaesth. 2015;115(3):444–8.

    Article  CAS  PubMed  Google Scholar 

  43. Hozumi J, Egi M, Sugita S, Sato T. Dose of intraoperative remifentanil administration is independently associated with increase in the risk of postoperative nausea and vomiting in elective mastectomy under general anesthesia. J Clin Anesth. 2016;34:227–31.

    Article  CAS  PubMed  Google Scholar 

  44. Sinclair DR, Chung F, Mezei G. Can postoperative nausea and vomiting be predicted? Anesthesiology. 1999;91:109–18.

    Article  CAS  PubMed  Google Scholar 

  45. Charbit B, Albaladejo P, Funck-Brentano C, Legrand M, Samain E, Marty J. Prolongation of QTc interval after postoperative nausea and vomiting treatment by droperidol or ondansetron. Anesthesiology. 2005;102:1094–100.

    Article  PubMed  Google Scholar 

  46. Krammes SK, Jacobs T, Clark JM, Lutes RE. Effect of intravenous ondansetron on the QT interval of patients’ electrocardiograms. Pediatr Emerg Care. 2016. [Epub ahead of print].

  47. Apfel CC, Läärä E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999;91:693–700.

    Article  CAS  PubMed  Google Scholar 

  48. Apfel CC, Kranke P, Eberhart LHJ. Comparison of surgical site and patient’s history with a simplified risk score for the prediction of postoperative nausea and vomiting. Anaesthesia. 2004;59:1078–82.

    Article  CAS  PubMed  Google Scholar 

  49. Biedler A, Wermelt J, Kunitz O, Muller A, Wilhelm W, Dethling J, Apfel CC. A risk adapted approach reduces the overall institutional incidence of postoperative nausea and vomiting. Can J Anaesth. 2004;51:13–9.

    Article  PubMed  Google Scholar 

  50. Smith CA, Ruth-Sahd L. Reducing the incidence of postoperative nausea and vomiting begins with risk screening: an evaluation of the evidence. J Perianesth Nurs. 2016;31(2):158–71.

    Article  PubMed  Google Scholar 

  51. Wiesmann T, Kranke P, Eberhart L. Postoperative nausea and vomiting—a narrative review of pathophysiology, pharmacotherapy and clinical management strategies. Expert Opin Pharmacother. 2015;16(7):1069–77.

    Article  CAS  PubMed  Google Scholar 

  52. Kolodzie K, Apfel CC. Nausea and vomiting after office-based anesthesia. Curr Opin Anaesthesiol. 2009;22:532–8.

    Article  PubMed  Google Scholar 

  53. Chinnappa V, Chung F. Post-discharge nausea and vomiting: an overlooked aspect of ambulatory anesthesia? Can J Anaesth. 2008;55:565–71.

    Article  PubMed  Google Scholar 

  54. Apfel CC, Philip BK, Cakmakkaya OS, Shilling A, Shi YY, Leslie JB, Allard M, Turan A, Windle P, Odom-Forren J, Hooper VD, Radke OC, Ruiz J, Kovac A. Who is at risk for postdischarge nausea and vomiting after ambulatory surgery? Anesthesiology. 2012;117:475–86.

    Article  PubMed  Google Scholar 

  55. Odom-Forren Jan, Jalota Leena, Moser Debra K, Lennie Terry A, Hall Lynne A, Holtman Joseph, Hooper Vallire, Apfel Christian C. Incidence and predictors of postdischarge nausea and vomiting in a 7-day population. J Clin Anesth. 2013;25:551–9.

    Article  PubMed  Google Scholar 

  56. Alghanem SM, Massad IM, Rashed EM, Abu-Ali HM, Daradkeh SS. Optimization of anesthesia antiemetic measures versus combination therapy using dexamethasone or ondansetron for the prevention of postoperative nausea and vomiting. Surg Endosc. 2010;24:353–8.

    Article  PubMed  Google Scholar 

  57. Tang J, Chen X, White PF, Wender RH, Ma H, Sloninsky A, Naruse R, Kariger R, Webb T, Zaentz A. Antiemetic prophylaxis for office-based surgery: are the 5-HT3 receptor antagonists beneficial? Anesthesiology. 2003;98(2):293–8.

    Article  CAS  PubMed  Google Scholar 

  58. Eberhart LH, Mauch M, Morin AM, Wulf H, Geldner G. Impact of a multimodal anti-emetic prophylaxis on patient satisfaction in high-risk patients for postoperative nausea and vomiting. Anaesthesia. 2002;57:1022–7.

    Article  CAS  PubMed  Google Scholar 

  59. Scuderi PE, James RL, Harris L, Mims GR 3rd. Multimodal antiemetic management prevents early postoperative vomiting after outpatient laparoscopy. Anesth Analg. 2000;91:1408–14.

    Article  CAS  PubMed  Google Scholar 

  60. Henzi I, Walder B, Tramèr MR. Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review. Anesth Analg. 2000;90:186–94.

    Article  CAS  PubMed  Google Scholar 

  61. Deban Singh L, Nando Singh Y, Ratan Singh N, Pradipkumar Singh L, Hemjit Singh T, Moirangthem GS. A comparison between granisetron and granisetron with dexamethasone for prevention of postoperative nausea and vomiting for laparoscopic cholecystectomy. JMS. 2009;23:51–4.

    Google Scholar 

  62. Chu CC, Shieh JP, Tzeng JI, Chen JY, Lee Y, Ho ST, Wang JJ. The prophylactic effect of haloperidol plus dexamethasone on postoperative nausea and vomiting in patients undergoing laparoscopically assisted vaginal hysterectomy. Anesth Analg. 2008;106:1402–6.

    Article  CAS  PubMed  Google Scholar 

  63. Habib AS, El-Moalem HE, Gan TJ. The efficacy of the 5-HT3 receptor antagonists combined with droperidol for PONV prophylaxis is similar to their combination with dexamethasone. A meta-analysis of randomized controlled trials. Can J Anaesth. 2004;51:311–9.

    Article  PubMed  Google Scholar 

  64. Maddali MM, Mathew J, Fahr J, Zarroug AW. Postoperative nausea and vomiting in diagnostic gynaecological laparoscopic procedures: comparison of the efficacy of the combination of dexamethasone and metoclopramide with that of dexamethasone and ondansetron. J Postgrad Med. 2003;49:302–6.

    CAS  PubMed  Google Scholar 

  65. Gan TJ, Franiak R, Reeves J. Ondansetron orally disintegrating tablet versus placebo for the prevention of postdischarge nausea and vomiting after ambulatory surgery. Anesth Analg. 2002;94:1199–200.

    Article  CAS  PubMed  Google Scholar 

  66. Tramèr MR. A rational approach to the control of postoperative nausea and vomiting: evidence from systematic reviews. Part I. Efficacy and harm of antiemetic interventions, and methodological issues. Acta Anaesthesiol Scand. 2001;45:4–13.

    Article  PubMed  Google Scholar 

  67. Gan TJ, Coop A, Philip BK. A randomized, double-blind study of granisetron plus dexamethasone versus ondansetron plus dexamethasone to prevent postoperative nausea and vomiting in patients undergoing abdominal hysterectomy. Anesth Analg. 2005;101:1323–9.

    Article  CAS  PubMed  Google Scholar 

  68. White PF, Watcha MF. Postoperative nausea and vomiting; prophylaxis versus treatment. Anesth Analg. 1999;89:1137–9.

    Article  Google Scholar 

  69. Habib AS, Reuveni J, Taguchi A, White WD, Gan TJ. A comparison of ondansetron with promethazine for treating postoperative nausea and vomiting in patients who received prophylaxis with ondansetron: a retrospective database analysis. Anesth Analg. 2007;104:548–51.

    Article  CAS  PubMed  Google Scholar 

  70. Habib AS, Gan TJ. The effectiveness of rescue antiemetics after failure of prophylaxis with ondansetron or droperidol: a preliminary report. J Clin Anesth. 2005;17:62–5.

    Article  CAS  PubMed  Google Scholar 

  71. Yazbeck-Karam VG, Siddik-Sayyid SM, Barakat HB, Korjian S, Aouad MT. Haloperidol versus ondansetron for treatment of established nausea and vomiting following general anesthesia: a randomized clinical trial. Anesth Analg. 2017;124(2):438–44.

    Article  CAS  PubMed  Google Scholar 

  72. Rüsch D, Eberhart LH, Wallenborn J, Kranke P. Nausea and vomiting after surgery under general anesthesia: an evidence-based review concerning risk assessment, prevention, and treatment. Dtsch Arztebl Int. 2010;107(42):733–41.

    PubMed  PubMed Central  Google Scholar 

  73. Rüsch D, Arndt C, Martin H, Kranke P. The addition of dexamethasone to dolasetron or haloperidol for treatment of established postoperative nausea and vomiting. Anaesthesia. 2007;62:810–7.

    Article  PubMed  Google Scholar 

  74. Sansonnens J, Taffé P, Burnand B, The ADS Study Group. Higher occurrence of nausea and vomiting after total hip arthroplasty using general versus spinal anesthesia: an observational study. BMC Anesthesiol. 2016;16:44–52.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Apfel CC, Turan A, Souza K, Pergolizzi J, Hornuss C. Intravenous acetaminophen reduces postoperative nausea and vomiting: a systematic review and meta-analysis. Pain. 2013;154(5):677–89.

    Article  CAS  PubMed  Google Scholar 

  76. Fearon JA, Dimas V, Ditthakasem K, Herbert MA. A randomized controlled trial of oral versus intravenous administration of a nonnarcotic analgesia protocol following pediatric craniosynostosis corrections on nausea and vomiting rates. J Craniofac Surg. 2015;26(6):1951–3.

    Article  PubMed  Google Scholar 

  77. White PF. What are the advantages of non-opioid analgesic techniques in the management of acute and chronic pain? Expert Opin Pharmacother. 2017. [Epub ahead of print].

  78. Gärtner R, Kroman N, Callesen T, Kehlet H. Multimodal prevention of pain, nausea and vomiting after breast cancer surgery. Minerva Anestesiol. 2010;76:805–13.

    PubMed  Google Scholar 

  79. Tan M, Law LS, Gan TJ. Optimizing pain management to facilitate enhanced recovery after surgery pathways. Can J Anaesth. 2015;62:203–18.

    Article  PubMed  Google Scholar 

  80. Azhar RA, Bochner B, Catto J, Goh AC, Kelly J, Patel HD, Pruthi RS, Thalmann GN, Desai M. Enhanced recovery after urological surgery: a contemporary systematic review of outcomes, key elements, and research needs. Eur Urol. 2016;70:176–87.

    Article  PubMed  Google Scholar 

  81. Peyton PJ, Wu CY. Nitrous oxide-related postoperative nausea and vomiting depends on duration of exposure. Anesthesiology. 2014;120(5):1137–45.

    Article  CAS  PubMed  Google Scholar 

  82. Myles PS, Chan MTV, Kasza J, Paech MJ, Leslie K, Peyton PJ, Sessler DI, Haller G, Beattie WS, Osborne C, Sneyd JR, Forbes A. Severe nausea and vomiting in the evaluation of nitrous oxide in the gas mixture for Anesthesia II Trial. Anesthesiology. 2016;124:1032–40.

    Article  CAS  PubMed  Google Scholar 

  83. Cheng CR, Sessler DI, Apfel CC. Does neostigmine administration produce a clinically important increase in postoperative nausea and vomiting? Anesth Analg. 2005;101:1349–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  84. Lee OH, Choi GJ, Kang H, Baek CW, Jung YH, Woo YC, Oh J, Park YH. Effects of sugammadex vs. pyridostigmine-glycopyrrolate on post-operative nausea and vomiting: propensity score matching. Acta Anaesthesiol Scand. 2016. [Epub ahead of print].

  85. Fan CF, Tanhui E, Joshi S, Trivedi S, Hong Y, Shevde K. Acupressure treatment for prevention of postoperative nausea and vomiting. Anesth Analg. 1997;84:821–5.

    Article  CAS  PubMed  Google Scholar 

  86. Alkaissi A, Evertsson K, Johnsson VA, Ofenbartl L, Kalman S. P6 acupressure may relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women. Can J Anaesth. 2002;49:1034–9.

    Article  PubMed  Google Scholar 

  87. Rusy LM, Hoffman GM, Weisman SJ. Electro-acupuncture prophylaxis of postoperative nausea and vomiting following pediatric tonsillectomy with or without adenoidectomy. Anesthesiology. 2002;96:300–5.

    Article  PubMed  Google Scholar 

  88. White PF, Issioui T, Hu J, Jones SB, Coleman JE, Waddle JP, Markowitz SD, Coloma M, Macaluso AR, Ing CH. Comparative efficacy of acustimulation (ReliefBand) versus ondansetron (Zofran) in combination with droperidol for preventing nausea and vomiting. Anesthesiology. 2002;97:1075–81.

    Article  CAS  PubMed  Google Scholar 

  89. Gan TJ, Jiao KR, Zenn M, Georgiade G. A randomized controlled comparison of electro-acupoint stimulation or ondansetron versus placebo for the prevention of postoperative nausea and vomiting. Anesth Analg. 2004;99:1070–5.

    Article  PubMed  Google Scholar 

  90. White PF, Zhao M, Tang J, Wender RH, Yumul R, Sloninsky AV, Naruse R, Kariger R, Cunneen S. Use of a disposable acupressure device as part of a multimodal antiemetic strategy for reducing postoperative nausea and vomiting. Anesth Analg. 2012;115(1):31–7.

    Article  PubMed  Google Scholar 

  91. Lee A, Fan LT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2009;15:CD003281.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. First Hospital of China Medical University, Shenyang, China

    Xuezhao Cao & Hong Ma

  2. Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Xuezhao Cao & Paul F. White

  3. The White Mountain Institute, The Sea Ranch, CA, USA

    Paul F. White

  4. Instituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy

    Paul F. White

Authors
  1. Xuezhao Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul F. White
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hong Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul F. White.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cao, X., White, P.F. & Ma, H. An update on the management of postoperative nausea and vomiting. J Anesth 31, 617–626 (2017). https://doi.org/10.1007/s00540-017-2363-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00540-017-2363-x

Keywords

Search

Navigation