Postoperative Vomiting in Children

Abstract

A survey of the incidence of postoperative vomiting in 1476 children was conducted over a two-month period as part of our quality assurance programme. The incidence of vomiting was 24 %, and was highest in children over three years of age and in those receiving opioids. The incidence is lower than that recorded in an earlier (1981) survey in our hospital. Changes in anaesthetic practices may have contributed to this decrease.

A quantitative systematic review of ondansetron in treatment of established postoperative nausea and vomiting

“…They noted that no more than a quarter of patients in the recovery room vomited in the immediate postanaesthetic period and that most of this vomiting was short lived and subsided spontaneously without anti-emetics. Similar average incidence of postoperative nausea and vomiting has been reported repeatedly, both in large randomised controlled trials21 and in case series,22 23 24 although it may be higher in specific clinical settings, such as paediatric strabismus surgery 25. In the ondansetron trials analysed here the average incidence of postoperative nausea and vomiting was 36% before starting treatment, suggesting that these trials accurately reflect common clinical practice.…”

The role of oral fluid intake following adeno-tonsillectomy

“…A greater than 50% rate of emesis following pediatric T&A has previously been reported [14]. In addition to the medical consequences of dehydration, aspiration and electrolyte imbalance, the psychological distress of post-operative emesis has been reported to exceed that of surgery in 54% of studied patients [17].…”

“…Multiple anesthetic, surgical, post-operative and patient related factors have been linked to dysphagia and emesis in this setting. Rates of emesis exceeding 50% following pediatric T&A have been previously reported [14]. The theoretical complications of refractory emesis including dehydration, electrolyte imbalance and aspiration have resulted in guidelines mandating tolerance of oral liquids prior to outpatient discharge.…”

Postoperative Übelkeit und postoperatives Erbrechen nach Strabismuschirurgie bei Kindern Inhalationsanästhesie mit Sevofluran/Lachgas im Vergleich zu intravenöser Anästhesie mit Propofol/Remifentanil

“…Postoperati ve Übelkeit und postoperatives Erbrechen (postoperative nausea and vomiting, PONV) stellen bei vielen kinderchirurgischen Eingriffen ein Problem dar [2,8,9,11,20,27]. Am stärksten ausgeprägt ist dieses Problem bekanntermaßen in der Strabismuschirurgie mit durchschnittlichen PONV-Raten von 59% [22], in einzelnen Erhebungen gar von 95 bzw.…”