Review article

Nausea and vomiting - the "big little problem" during recovery after anesthesia

Tatjana Šimurina orcid.org/0000-0002-2657-5537 ; Opća bolnica Zadar, Odjel za anesteziologiju, reanimatologiju i intenzivnu medicinu; Sveučilište u Zadru, Odjel za zdravstvene studije; Sveučilište u Osijeku "Josip Juraj Strossmayer", Medicinski fakultet
Nina Sulen ; Opća bolnica Zadar, Odjel za anesteziologiju, reanimatologiju i intenzivnu medicinu; Sveučilište u Zadru, Odjel za zdravstvene studije; Sveučilište u Osijeku "Josip Juraj Strossmayer", Medicinski fakultet
Marija Kojić ; Sveučilište u Zadru, Odjel za zdravstvene studije
Boris Mraović ; Department of Anesthesiology and Perioperative Medicine, University of Missouri

Abstract

Postoperative nausea and vomiting (PONV) are the most common and very unpleasant side effects after general anesthesia. Despite modern anesthetics and non-invasive surgical techniques, the overall incidence still remains high. It is about 30% even with PONV prophylaxis, but can go as high as 80% without prophylaxis. The etiology of PONV is complex and has a multifactorial cause, including patients, anesthetic and surgical risk factors. An assessment of the PONV risk factors helps anesthesiologists to use appropriate antiemetic prophylaxis. The management of PONV includes a strategy for reducing baseline risks, administration of antiemetic prophylaxis for moderate and high risk patients, and rescue treatment if PONV prophylaxis failed. The patient‘s baseline risk should be objectively assessed using a validated risk score with known predictors. The incidence of PONV predicted by predictive models has moderate accuracy. Althoughcurrent predictive models for PONV are practical tools in PONV risk stratification, a more individual approach to each patient is needed to identify patients with more severe PONV. Anesthesiologists' clinical experience and knowledge on the efficacy and safety of pharmacological and non-pharmacological antiemetic methods improve a patient satisfaction, while reducing postoperative morbidity and medical costs. New research on the role of genes in the response to antiemetic agents suggests that PONV prophylaxis and treatment could be tailored for each patient individually.

Keywords

antiemetic; nausea; postoperative nausea and vomiting; prophylaxis; vomiting

Hrčak ID:

187159

URI

https://hrcak.srce.hr/187159

Publication date:

3.10.2017.

Article data in other languages: croatian

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