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[Postoperative nausea and vomiting (PONV). Clinical significance, basic principles, prevention and therapy]
C Simanski1, H H Waldvogel, E Neugebauer
1Chirurgische Klinik Köln-Merheim, II. Chirurgischer Lehrstuhl der Universität Köln. Christian.Simanski@uni-koeln.de
Introduction:
The incidence of postoperative nausea and vomiting (PONV) of in- and outpatient surgical patients is about 30% (range 2-45%).
Methods:
Based on etiology, anatomy and physiology, this review article provides a critical evaluation of the present PONV literature with the aim of outlining current prophylaxis and treatment strategies.
Results:
PONV is often associated with postoperative pain and its treatment. Patients are often more compromised by PONV than by postoperative pain. Surveys demonstrate that 78% of the surgeons consider PONV to be a relevant problem in clinical practice; 82% argue for better management of PONV. However, only 28% of the general surgical patients with PONV received sufficient antiemetic therapy. Studies demonstrate that the prophylactic use of antiemetics in patients at risk can lead to complete symptom control in 85% of the cases. Combination therapy of different antiemetic strategies can further increase the rate up to 96%.
Conclusion:
There is a need for surgeons to pay more attention to patient-related symptoms.