[Postoperative nausea and vomiting (PONV). Clinical significance, basic principles, prevention and therapy].
BACKGROUND
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%.


CONCLUSIONS
There is a need for surgeons to pay more attention to patient-related symptoms.
Simanski
C
C
Chirurgische Klinik Köln-Merheim, II. Chirurgischer Lehrstuhl der Universität Köln. Christian.Simanski@uni-koeln.de
Waldvogel
H H
HH
Neugebauer
E
E
D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D000932:Antiemetics / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors
D000701:Analgesics, Opioid; D000932:Antiemetics