Postoperative Nausea and Vomiting

PONV is a common complication of surgery and can lead to delayed discharge and unanticipated hospitalization. The overall incidence of PONV for all surgeries and patient populations is 25% to 30%, but PONV can occur in 70% to 80% of high-risk patients.7,9,11 Risk factors for PONV include patient factors (female gender, nonsmoking status, and history of PONV or motion sickness), anesthetic factors (use of volatile anesthetics, nitrous oxide, or intraoperative or postoperative opioids), and surgical factors (duration and type of surgery). ,9-11

The first step in preventing PONV is reducing baseline risk factors when appropri-

ate. ' For example, the incidence of PONV may be less with regional anesthesia than general anesthesia, and nonsteroidal anti-inflammatory drugs may cause less PONV than opioid analgesics.

O Droperidol or a 5-HT3 receptor antagonist should be administered at the end of surgery to patients at high risk for developing PONV.1'7'8'11'54 Dexamethasone is

7 54

also effective when given as a single dose prior to induction of anesthesia. ' Antich-

olinergics and antihistamines are also effective for preventing PONV.

Table 20-4 Recommended Drug Regimens for Prevention of CINV Based on Emetogenic Risk

Emula^niC Risk

Acute CIHVI Day 1]

Di-l^/cd CINV (D.iyi 1-*)

M klfeiul

Mono

NOJVP

LC*r

tieBpmei ha^cirw*

^jodera&i

Non-At apy regimsn

S KT, anragonist + rtejiamethasorie

S-hT antagonlsTiy da<aririeihasone

iAjyi 1

AjC chemotherapy legimen

5 KT! antagonist t cfeKimtrfhasone v

Aprepitant a (Jexjmiflhasone

apnpMm

Wujfs 2 ind 3}

High

S HT, antagonist t cfcuanwihasone +■

Anfifpilant (days 1 and 20 +■

apiefMHm

dtMmtUySOne (diyi 2-f)

AC, anthidcydinc tcJaunotutjtin.dDWDfutnOni:. t:u rutiicin. or idai iAmoiiO f^us cjmltjphosphsmidpjCINV chcmolhtfjpy-induGt.'d nuuMia and wnfflnot rrom ReftS, IMM/

AC, anthidcydinc tcJaunotutjtin.dDWDfutnOni:. t:u rutiicin. or idai iAmoiiO f^us cjmltjphosphsmidpjCINV chcmolhtfjpy-induGt.'d nuuMia and wnfflnot rrom ReftS, IMM/

Natural Vertigo And Dizziness Relief

Natural Vertigo And Dizziness Relief

Are you sick of feeling like the whole world Is spinning out of control. Do You Feel Weak Helpless Nauseous? Are You Scared to Move More Than a Few Inches From The Safety of Your Bed! Then you really need to read this page. You see, I know exactly what you are going through right now, believe me, I understand because I have been there & experienced vertigo at it's worst!

Get My Free Ebook


Post a comment