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Published on: June 21, 2024
Postoperative nausea and vomiting (PONV) in children
K Heyland1, P Dangel, A C Gerber
1Department of Anaesthesiology, University Children's Hospital Zurich, Switzerland.
Summary
Postoperative nausea and vomiting (PONV) are common in children. High-risk groups and specific anesthetic agents influence PONV incidence, suggesting targeted antiemetic prophylaxis and anesthetic adjustments can reduce complications.
Area of Science:
- Anesthesiology
- Pediatric Surgery
Background:
- Postoperative nausea and vomiting (PONV) are frequent complications following anesthesia in children.
- Understanding the multifactorial etiology of PONV is crucial for effective management.
Purpose of the Study:
- To investigate the causes of PONV in pediatric patients.
- To identify strategies for reducing the incidence of PONV.
Main Methods:
- Prospective study of 780 pediatric patients undergoing anesthesia.
- Analysis of patient demographics, medical history, anesthetic agents, and surgical procedures in relation to PONV occurrence.
Main Results:
- PONV incidence was 34.4% for vomiting and 39.3% for nausea.
- Younger children (<2 years) and older boys (>13 years) vomited less, while older girls (>13 years) vomited more.
- Propofol use decreased PONV; neuromuscular reversal agents, opioids, motion sickness history, and prior PONV increased PONV risk.
Conclusions:
- High-risk pediatric patients (e.g., girls >13 years, history of motion sickness) undergoing certain procedures benefit from prophylactic antiemetics.
- Adjusting anesthetic techniques, including wider propofol use, NSAIDs or regional analgesia over opioids, and avoiding neuromuscular reversal agents, can mitigate PONV.
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