Postoperative nausea and vomiting: a review of current literature

Postoperative nausea and vomiting (PONV) is one of the commonest complaints following anaesthesia, and can result in morbidity like wound dehiscence, bleeding, pulmonary aspiration of gastric contents, fluid and electrolyte disturbances, delayed hospital discharge, unexpected hospital admission, and decreased patient satisfaction.

A literature search was done on the Medline and relevant articles chosen.

Despite the vast amount of research done in this field and the variety of antiemetic drugs available, PONV still has a high incidence. Many factors are associated with PONV. Quantifying the relative impact of risk factors on PONV has resulted in the development of risk models, which can stratify risk categories and hence allow the anaesthetist to identify those patients at higher risk for PONV. The management of PONV requires a multi-modal approach which can include the use of less emetogenic anaesthetic techniques, balanced analgesia, appropriate intravenous hydration, the use of pharmacotherapy and possibly non-pharmacologic methods.

The use of risk models facilitates the judicious use of pharmacotherapy to ameliorate PONV especially in the high-risk patient and may lead to a more cost effective and efficient means of managing PONV.