Postoperative Nausea and Vomiting in Paediatric Anaesthesia

Area of Science:

• Anesthesiology
• Pediatric Medicine
• Pharmacology

Background:

• Postoperative nausea and vomiting (PONV) is a frequent complication in pediatric anesthesia, leading to significant patient morbidity.
• Identified risk factors for pediatric PONV include elevated postoperative pain scores, opioid use, and volatile anesthetic agents.

Purpose of the Study:

• To review current literature on the prevention and treatment of PONV in pediatric patients.
• To provide comprehensive information on risk factors, common pharmacotherapies, and guidelines for PONV management in children.

Main Methods:

• Literature search of the PubMed database for clinical trials, systematic reviews, and meta-analyses.
• Synthesis of findings regarding risk factors, prophylactic pharmacotherapy, and treatment strategies for pediatric PONV.

Main Results:

• Risk factors for PONV in children include pain, opioids, and volatile anesthetics.
• Multimodal non-opioid analgesia, total intravenous anesthesia, and prophylactic pharmacotherapy (corticosteroids, 5HT3 antagonists, anticholinergics) can mitigate PONV risk.
• Clinical application of findings can reduce PONV incidence in pediatric patients.

Conclusions:

• While complete avoidance of PONV is challenging, risk can be substantially reduced through strategic anesthetic and analgesic choices.
• Prophylactic pharmacotherapy with specific drug classes is a key component in managing pediatric PONV.
• Updated information on risk factors and management guidelines aids clinicians in reducing PONV occurrence in children.