Prevention and treatment of postoperative nausea and vomiting.

@article{Golembiewski2005PreventionAT,
  title={Prevention and treatment of postoperative nausea and vomiting.},
  author={Julie A. Golembiewski and E L Chernin and Tania Chopra},
  journal={American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists},
  year={2005},
  volume={62 12},
  pages={
          1247-60; quiz 1261-2
        }
}
  • J. Golembiewski, E. Chernin, T. Chopra
  • Published 15 June 2005
  • Medicine
  • American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
PURPOSE The physiology, risk factors, and prevention and treatment of postoperative nausea and vomiting (PONV) are discussed. SUMMARY Factors to consider when determining a patient's risk for PONV include sex, history of PONV, history of motion sickness, smoking status, duration of anesthesia, use of opioids, and type of surgery. Receptors that, when activated, can cause nausea or vomiting or both include dopamine type 2, serotonin type 3, histamine type 1, and muscarinic cholinergic type 1… 
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Promethazine in the treatment of postoperative nausea and vomiting: a systematic review
TLDR
The results of this review support the finding that promethazine is not recommended as a first-line agent in the treatment of PONV, but can be considered for use as a rescue antiemetic.
Prevention and treatment of postoperative nausea and vomiting.
TLDR
A systematic approach with analysis of preoperative risk factors and prescription of medication can be effective for prevention of postoperative nausea and vomiting.
Risk factors of patients with and without postoperative nausea (PON).
Palonosetron versus ondansetron for prevention of postoperative nausea and vomiting during middle ear surgery: a double-blind, randomized, comparative trial
TLDR
The aim of this study was to assess the effi cacy and safety of palonosetron versus ondansetron for PONV during middle ear surgery (MES).
Biphasic dosing regimen of meclizine for prevention of postoperative nausea and vomiting in a high-risk population.
TLDR
It is recommended that the administration of 50 mg of oral meclizine the night before and on the day of surgery be considered effective antiemetic prophylaxis in patients identified as having a high risk for PONV.
Nausea and vomiting
TLDR
The key to managing most cases of nausea and vomiting lies in a good history and a detailed physical examination, and knowledge regarding various emetic pathways and the specific neurotransmitters involved helps to target therapy.
Efficacy of prophylactic dexamethasone in prevention of postoperative nausea and vomiting
The effects of amounts of intraoperative intravenous fluid administration on postoperative nausea and vomiting during gynecological surgery
TLDR
Intraoperative large volume infusion of lactated Ringer’s solution was ineffective in reducing the incidence of PONV in patients scheduled for gynecological surgery during the postoperative period.
Preventing postoperative nausea and vomiting after laparoscopic cholecystectomy: a prospective, randomized, double-blind study.
Aromatherapy for postoperative nausea and vomiting
TLDR
From the evidence of the systematic review, the use of isopropyl alcohol vapour inhalation as an adjunct therapy for postoperative nausea and vomiting is unlikely to be harmful and may reduce nausea for some adult patients.
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References

SHOWING 1-10 OF 113 REFERENCES
Postoperative nausea and vomiting--can it be eliminated?
TLDR
Although PONV is rarely fatal, it is an unpleasant postoperative symptom (BOX), and even mild PonV can delay hospital discharge, decrease patient satisfaction, and increase use of resources.
Dexamethasone for the Prevention of Postoperative Nausea and Vomiting: A Quantitative Systematic Review
TLDR
It is very likely that the best prophylaxis of postoperative nausea and vomiting currently available is achieved by combining dexamethasone with a 5-HT3 receptor antagonist.
A rational approach to the control of postoperative nausea and vomiting: evidence from systematic reviews. Part II. Recommendations for prevention and treatment, and research agenda
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  • Medicine
    Acta anaesthesiologica Scandinavica
  • 2001
TLDR
The intention of this second part of a series of two papers on rational strategies to control PONV symptoms was to provide clinically applicable recommendations based on data which represent the highest level of evidence currently available on efficacy and harm of antiemetic interventions.
Postoperative Nausea and Vomiting: Its Etiology, Treatment, and Prevention
TLDR
Patients at high risk for postoperative emesis should receive special considerations with respect to the prophylactic use of antiemetic drugs, as suggested in a recent editorial.
Postoperative nausea and vomiting
  • M. Kreis
  • Medicine
    Autonomic Neuroscience
  • 2006
Supplemental oxygen reduces the incidence of postoperative nausea and vomiting.
TLDR
Since supplemental O2 is inexpensive and essentially risk-free, it appears preferable to pharmacologic anti-emetics for prevention of PONV in abdominal surgery.
A factorial trial of six interventions for the prevention of postoperative nausea and vomiting.
TLDR
Ondansetron, dexamethasone, and droperidol each reduced the risk of postoperative nausea and vomiting by about 26 percent, and the safest or least expensive antiemetic interventions should be used first.
Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting
TLDR
Droperidol is anti-emetic in the surgical setting, Sedation and drowsiness are dose-dependent, extrapyramidal symptoms are rare, and there is a protective effect against headache.
Treatment of established postoperative nausea and vomiting: a quantitative systematic review
TLDR
Of 100 vomiting surgical patients receiving a 5-HT3 receptor antagonist, 20 to 30 will stop vomiting who would not have done so had they received a placebo; less will profit from the anti-nausea effect.
Evaluation of the effective drugs for the prevention of nausea and vomiting induced by morphine used for postoperative pain: a quantitative systematic review.
TLDR
Of them, dexamethasone used as a prophylactic drug for PONV provided the best results, and is suggested to be suitable as a first drug of choice.
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