Multimodal antiemetic therapy and emetic risk profiling.
BACKGROUND
Postoperative nausea and vomiting (PONV) is a common problem with no simple solution. This review highlights factors that are known to increase the risk of PONV. It examines the various data on pharmacological and non-pharmacological methods that have been used to prevent PONV.


METHODS
Peer-reviewed journals on the subject were covered.


CONCLUSIONS
Patient, surgical and anaesthetic factors increase the risk of PONV. While patient and surgical factors are understandably difficult to control, a multimodal approach involving both pharmacological and non-pharmacological interventions has been successfully adopted to reduce the incidence of PONV. Various factors have been identified to categorise patients into different profiles to determine their risk of PONV. Perioperative strategies can then be targeted at these patient groups.
Ho
K Y
KY
Department of Anaesthesia and Surgical Intensive Care, Singapore General Hospital, Singapore.
Chiu
J W
JW
D000768:Anesthesia, General; D000932:Antiemetics / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D003907:Dexamethasone / Q000494:pharmacology; D004329:Droperidol / Q000494:pharmacology; D004359:Drug Therapy, Combination; D006801:Humans; D008565:Membrane Proteins; D008787:Metoclopramide / Q000008:administration & dosage; D010100:Oxygen / Q000627:therapeutic use; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D011292:Premedication; D012307:Risk Factors; D012702:Serotonin Antagonists / Q000494:pharmacology; D025521:Tumor Suppressor Proteins
D000932:Antiemetics; D008565:Membrane Proteins; D012702:Serotonin Antagonists; C449281:TMEM158 protein, human; D025521:Tumor Suppressor Proteins; D003907:Dexamethasone; D008787:Metoclopramide; D004329:Droperidol; D010100:Oxygen