title: Prevention and treatment of postoperative nausea and vomiting.
abstract: Postoperative nausea and vomiting are common and can be prevented. Complications of this condition cause higher rates of morbidity and mortality. A review of literature was carried out on MEDLINE, with focus on controlled clinical trials. Pathophysiology is complex, with many afferent and efferent pathways, and its comprehension facilitate the choice of medication. Risk factors are presented, with a stratified score of chance to develop postoperative nausea and vomiting. An algorithm for identification of higher risk patients was elaborated and classified the level of prevention/treatment recommended to avoid excessive use of drugs and their side effects. Postoperative nausea and vomiting must be prevented, because of the involved complications and discomfort for patients. A systematic approach with analysis of preoperative risk factors and prescription of medication can be effective for prevention.
authors.affiliation: Unidade de Terapia Intensiva, Casa de Saúde São José, Rio de Janeiro, RJ, Brasil.
authors.forename: Carlos Roberto Naegeli
authors.initials: CR
authors.lastname: Gondim
authors.affiliation: Unidade de Terapia Intensiva, Casa de Saúde São José, Rio de Janeiro, RJ, Brasil.
authors.forename: André Miguel
authors.initials: AM
authors.lastname: Japiassú
authors.affiliation: Departamento de Cirurgia Geral e Especializada, Escola de Medicina, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Pedro Eder
authors.initials: PE
authors.lastname: Portari Filho
authors.affiliation: Unidade de Terapia Intensiva, Casa de Saúde São José, Rio de Janeiro, RJ, Brasil.
authors.forename: Gustavo Ferreira de
authors.initials: GF
authors.lastname: Almeida
authors.affiliation: Unidade de Terapia Intensiva, Casa de Saúde São José, Rio de Janeiro, RJ, Brasil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Kalichsztein
authors.affiliation: Unidade de Terapia Intensiva, Casa de Saúde São José, Rio de Janeiro, RJ, Brasil.
authors.forename: Gustavo Freitas
authors.initials: GF
authors.lastname: Nobre