Postanesthetic Nausea, Vomiting, and Retching

Knapp, M. Robert

doi:10.1001/jama.1956.02960400034009

Cited by 76 publications

(12 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The relationship between the incidence of PONV and age has been difficult to clarify from the literature, partly because of the effects of confounding uncontrolled variables such as premedication, gender, surgical case mix, anaesthetic technique and the duration of postoperative data collection. In spite of the effects ofthese confounding variables, there is evidence that the incidence of PONV changes with age: the incidence is least (5 %) in infants « 12 months of age) [19], increases to 20% in children less than 5 yr of age [19,71,86], to a maximum of 34-51 % in late childhood ( [8,16,17,20,24,46,68,74,80,85] and into the eighth decade [8,47,59,74].…”

Section: Agementioning

confidence: 99%

Surgical and Patient Factors Involved in Postoperative Nausea and Vomiting

Lerman¹

1992

British Journal of Anaesthesia

382

220

View full text Add to dashboard Cite

Seventy-five years ago, Flagg suggested that postoperative vomiting may result from causes other than anaesthetics: "there are at least three kinds of vomiting", the first of which he attributed to anaesthetics such as ether, the second to reflex responses, that is pain or ovarian surgery, and the last to opioids, for example morphine [30]. Before this report, anaesthetics alone were thought to be responsible for most postoperative nausea and vomiting (PONV). Subsequent investigations unfolded a spectrum of non-anaesthetic factors in the pathogenesis of PONY including age, gender, motion sickness, body habitus, surgical site and postoperative feeding procedures. This review summarizes our current understanding of the roles of two categories of non-anaesthetic factors, patient and surgical factors, in the pathogenesis of PONY. Despite the recent advances in modern anaesthesia, only modest progress has been made in our understanding and treatment of PONY. Early studies reported incidences of PONY as high as 75-80 cYo after opioid premedication and prolonged ether anaesthesia [4,11,13,47,83,84]. In many of these reports, the patient population, premedication, anaesthetic and the surgical procedure were not controlled. In the second half of this century, however, these incidences have decreased by almost 50 % for various reasons [7,

show abstract

Section: Agementioning

confidence: 99%

Surgical and Patient Factors Involved in Postoperative Nausea and Vomiting

Lerman¹

1992

British Journal of Anaesthesia

382

220

View full text Add to dashboard Cite

show abstract

“…Die höchste PONV-Inzidenz von 50% wird im adoleszenten Alter festgestellt [40,41], während sie bei Säuglingen, Kleinkindern und Greisen wesentlich geringer (5-20%) ist [41,42]. Die durchschnittliche Inzidenz bei Erwachsenen wird mit durchschnittlich 30% beziffert [43].…”

Section: Prädisponierende Faktoren Für Ponvunclassified

Postoperative Übelkeit und Erbrechen in den operativen Disziplinen

Simanski¹

2007

Visc Med

View full text Add to dashboard Cite

Postoperative Nausea and Vomiting in Surgical Gastroenterology Postoperative nausea and vomiting (PONV) and acute postoperative pain are the most harmful symptoms for the patient. Nevertheless, a high-dose postoperative pain therapy can lead to PONV, beside special anesthetic procedures. Although pain therapy has become more and more comfortable, an incidence of PONV of 30% has been reported in in- and outpatient procedures in the literature. 78% of the responsible surgeons declared PONV as a daily routine problem, 82% would like to have a better PONV management. In contrast to this, only 28% of the general surgical patients received an antiemetic therapy. This review analyzes the actual procedures for prophylaxis and therapy of PONV. A prophylaxis with antiemetic drugs can prevent PONV in 85% of the patients. A combination of PONV-relieving drugs resulted in 96% of PONV-free patients. The responsible surgeon therefore should be aware of this problem and of the effective treatment strategies to avoid PONV.

show abstract

“…Ihre antiemetische Wirksamkeit wird auf Blockade zentraler Dopaminrezeptoren zurückgeführt. Da Phenothiazine jedoch neuroleptische Eigenschaften haben, ist nach ihrer Gabe mit Nebenwirkungen wie Dysphorie, Sedation und Lethargie zu rechnen [46,61]. Ein Phenothiazin mit geringerer sedativer Komponente, Dixyrazin, konnte erfolgreich bei Strabismuskorrekturen zur Emesisprophylaxe bei Kindern eingesetzt werden.…”

Section: Phenothiazineunclassified

Postoperative Nausea und Emesis: Mechanismen und Behandlung

Unkel¹,

Peters²

1998

Anästhesiol Intensivmed Notfallmed Schmerzther

View full text Add to dashboard Cite

The incidence of postoperative emetic symptoms in patients varies between 3 and 91%. Nausea and emesis remain the most common as well as unpleasant side-effects experienced by patients following general anaesthesia, both in the ambulatory and non-ambulatory care setting. Furthermore, emesis carries the risk of severe postoperative complications and is associated with additional costs. Multiple factors are associated with an increased risk of developing postoperative nausea and emesis including age, gender, weight, preexisting disease, as well as anaesthetic and surgical procedures. Routine antiemetic prophylaxis is not currently advisable in patients with a low Emesis Risk, due to undesirable side-effects of antiemetics and additional costs. However, anti-emetic prophylaxis is recommended for patients with an increased risk. Besides administration of antiemetics, other factors that may provoke postoperative emesis need to be considered such as gastric distension, early mobilisation, insufficient analgesia, choice of anaesthetic drugs. High-risk patients may be anaesthetized with propofol, if possible. If symptoms do develop in the recovery room, tight fitting oxygen masks should be avoided and adequate hydration and analgesia ensured. To avoid side effects, antiemetics should be administered in minimally effective dosages. If emesis persists, combination of antiemetic drugs with different profiles of receptor action may be particularly useful.

show abstract

Postanesthetic Nausea, Vomiting, and Retching

Cited by 76 publications

References 16 publications

Surgical and Patient Factors Involved in Postoperative Nausea and Vomiting

Surgical and Patient Factors Involved in Postoperative Nausea and Vomiting

Postoperative Übelkeit und Erbrechen in den operativen Disziplinen

Postoperative Nausea und Emesis: Mechanismen und Behandlung

Contact Info

Product

Resources

About