The management of post-operative nausea and vomiting

Despite the advent of new technology and pharmacological agents, post-operative nausea and vomiting (PONV) continues to have an incidence of 20-30% today. Development of PONV can lead to serious complications such as aspiration, dehydration, electrolyte disturbances and disruption of the surgical site. PONV leads to increased cost of treatment, and may be associated with increased anxiety, dissatisfaction with the surgical experience and anticipatory nausea in the future. The mechanisms of PONV are examined with associated risk factors. A review of the literature of PONV management is included covering pharmacological, dietary and behavioural interventions; culminating in the development of assessment and management guidelines and identification of areas for further study.