Postoperative nausea and vomiting (PONV): still “the little big problem”?

Jan Jakobsson

in Anaesthesia for Day Case Surgery

Published on behalf of Oxford University Press

Published in print May 2012 | ISBN: 9780199652969
Published online October 2012 | e-ISBN: 9780191742972 | DOI:

Series: Oxford Anaesthesia Library

Postoperative nausea and vomiting (PONV): still “the little big problem”?

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  • Anaesthetics
  • Clinical Pharmacology and Therapeutics


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• Postoperative nausea and vomiting (PONV) is not only distressing but delays discharge; all efforts should be made to reduce its occurrence and to minimize the distress caused when it is experienced. • PONV is a common problem after day case anaesthesia with a huge impact both on patient satisfaction and discharge/logistics. • Risk-stratification and multi-modal prophylaxis should be administered accordingly. • Triple prophylaxis has been shown to be effective although it does not entirely eliminate the risk in high-risk patients. • All measures should be sought to provide adequate pain management with as little opioid administered as possible. • Appropriate hydration, heart rate, and blood pressure should be secured. • Even when all measures are taken there is still a risk in the high emetogenic group of patients. • An adequately informed patient can without doubt be sent home while still experiencing PONV, as resting in the home environment is many times more satisfactory that in the day care facilities; Patients sent home with ongoing PONV should be informed how to act in case of prolonged symptoms beyond 48 hours.

Chapter.  2510 words.  Illustrated.

Subjects: Anaesthetics ; Clinical Pharmacology and Therapeutics

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