Nausea and vomiting after surgery:  it is not just postoperative.
OBJECTIVE
The purpose of this review is to highlight postoperative nausea and vomiting (PONV), to discuss why it occurs, how it might be prevented and then how it can be treated.


RESULTS
PONV/postdischarge nausea and vomiting (PDNV) is a problem that patients identify as one of the worst, if not the worst problem that can occur after surgery. Therapy is not perfect, yet there are anaesthesia techniques that can help minimize the problem and drugs that can be used both to prevent and also treat the problem once it occurs. There is a genetic basis for why some people experience PONV/PDNV more than others and also why treatment for some is better than others.


CONCLUSIONS
It is easy to turn the vapourizer dial, but that is a part of the problem. Not everyone reacts the same to drugs. Although PDNV is not as well characterized as PONV, at the very least, avoid an anaesthetic that may make PONV/PDNV worse and be aggressive in treating the problem.
Department of Anesthesiology, Yale University School of Medicine, New Heaven, Connecticut 06520-8051, USA. lance.lichtor@yale.edu
J Lance
JL
Lichtor
D000556:Ambulatory Surgical Procedures; D000758:Anesthesia / Q000009:adverse effects; D000932:Antiemetics / Q000627:therapeutic use; D006801:Humans; D010351:Patient Discharge; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*
D000932:Antiemetics