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Review
. 2021 Dec 1;34(6):695-702.
doi: 10.1097/ACO.0000000000001063.

Management of postoperative nausea and vomiting in adults: current controversies

Niraja Rajan  1 , Girish P Joshi  2
Affiliations
Review

Management of postoperative nausea and vomiting in adults: current controversies

Niraja Rajan et al. Curr Opin Anaesthesiol. .

Abstract

Purpose of review: Postoperative nausea and vomiting (PONV) continue to plague the surgical patient population with an adverse impact on postoperative outcomes. The aim of this review is to critically assess current evidence for PONV management, including studies evaluating baseline risk reduction and antiemetic prophylaxis, to provide a pragmatic approach to prevention and treatment of PONV in routine clinical practice.

Recent findings: Multiple recent reviews and guidelines have been published on this topic with some limitations. In the current ERAS era, all patients irrespective of their PONV risk should receive two to three antiemetics for prophylaxis. Patients at a high risk of PONV [i.e. prior history of PONV, history of motion sickness, high opioid requirements after surgery (e.g. inability to use nonopioid analgesic techniques)] should receive three to four antiemetics for prophylaxis.

Summary: This review provides a practical approach to PONV prevention based on recent literature.

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References

    1. Gan TJ, Belani KG, Bergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2020; 131:411–448.
    1. McLoughlin S, Terrasa SA, Ljungqvist O, et al. Nausea and vomiting in a colorectal ERAS program: Impact on nutritional recovery and the length of hospital stay. Clin Nutr 2019; 34:73–80.
    1. Kehlet H, Joshi GP. Enhanced recovery after surgery: current controversies and concerns. Anesth Analg 2017; 125:2154–2155.
    1. Joshi GP, Kehlet H. Enhanced recovery pathways: looking into the future. Anesth Analg 2019; 128:5–7.
    1. Schraag S, Pradelli L, Alsaleh AJO, et al. Propofol vs. inhalational agents to maintain general anaesthesia in ambulatory and in-patient surgery: a systematic review and meta-analysis. BMC Anesthesiol 2018; 18:162.

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