Prevention of postoperative nausea and vomiting
Sheila M Wilhelm1, Michelle L Dehoorne-Smith, Pramodini B Kale-Pradhan
1Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA.
The Annals of Pharmacotherapy
|January 4, 2007
Summary
Preventing postoperative nausea and vomiting (PONV) involves assessing risk factors and using prophylactic antiemetic medications for high-risk patients. Combination therapy may be needed, with rescue antiemetics for those who develop PONV.
Area of Science:
- Anesthesiology
- Pharmacology
- Evidence-Based Medicine
Background:
- Postoperative nausea and vomiting (PONV) is a common complication following surgical procedures.
- Effective prevention and management strategies are crucial for patient recovery and satisfaction.
Purpose of the Study:
- To conduct a literature review on the prevention and treatment of PONV in adult patients.
- To synthesize evidence regarding the efficacy and cost-effectiveness of various antiemetic therapies.
Main Methods:
- Comprehensive literature search of MEDLINE database (1966-2006) and hand-searching of article references.
- Inclusion of English-language studies focusing on PONV prevention and treatment in adults.
- Evaluation of evidence for prophylactic and rescue antiemetic strategies.
Main Results:
- Prophylactic antiemetic medications are recommended for high-risk surgical patients.
- 5-HT3 receptor antagonists are commonly used, but cost-effectiveness varies among agents.
- Evidence supports the use of multiple antiemetic classes for prophylaxis and rescue therapy.
Conclusions:
- Risk factor assessment and reduction are primary steps in PONV prevention.
- Pharmacologic interventions are the mainstay for PONV management, complemented by nonpharmacologic therapies.
- Moderate to high-risk patients require prophylactic antiemetics, potentially in combination, and rescue therapy with different agents if PONV occurs.
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