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Post-Anesthesia Nausea and Vomiting: A Review of Pathophysiology, Treatment, and Prevention
Current Issue
Volume 3, 2015
Issue 3 (June)
Pages: 74-82   |   Vol. 3, No. 3, June 2015   |   Follow on         
Paper in PDF Downloads: 33   Since Aug. 28, 2015 Views: 1750   Since Aug. 28, 2015
Henry H. Rowshan, Oral and Maxillofacial Surgeon, Private Practice, Bellevue, Washington, USA.
Hooman Rowshan, Research Associate, University of Florida, Gainesville, FL, USA.
Ali R. Elyassi, Oral and Maxillofacial surgery resident, Tripler Army Medical Center, Honolulu, HI, USA.
Despite all advances in the science and art of anesthesia and surgery, Pos-Anesthesia Nausea and Vomiting (PANV) continues to be a common problem with an average incidence rate of 20-30%. 1 Most patients express concern about PANV and are more worried about it than they are about postoperative pain. These patients readily are willing to pay more for their anesthesia care in order to avoid this discomforting experience. PANV has a very low morbidity rate, however, it has been linked to aspiration pneumonitis, suture wound dehiscence, dehydration, electrolyte imbalance, and hematoma formation in the surgical sites. Additionally, patients may experience delayed discharge from the surgical facility, prolonged nursing care, and unanticipated hospital admission leading to significant increase in health care costs.2-4The dentist anesthesiologist is at the forefront of ambulatory anesthesia care and must be familiar with the pathophysiology, pharmacological, non-pharmacological management, and preventive measures pertaining to PANV.
Anesthesia, Nausea, Vomiting, Post-Operative, Post-Anesthesia Nausea, Emesis, Postoperative Nausea and Vomiting Management and Prevention
Watcha MF, White PF. Postoperative nausea and vomiting: Its Etiology, Treatment and Prevention. Anesthesiology 1992;77:162-84.
Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid. The perspective of patients. Anesth Analog 1999;89:652-658.
Gan T, Sloan F, Dear Gde L. How much are patients willing to pay to avoid postoperative nausea and vomiting? Anesth Analog 2001;92:393-400.
Macario A. Which clinical anesthesia outcomes are important to avoid? The perspective of a panel of expert anesthesiologists. Anesth Analg, 1999;88:1085-91.
Saeeda Islam, Jain P.N. Post-operative nausea and vomiting, A review article. Indian Journal of Anesthesia, 2004;48(4):253-258.
Rahman, Mohamed H, Beattie, Jane. Post-operative nausea and vomiting. The Pharmaceutical Journal. 2004 (273) 786-788.
Wang SC, Borison HL. The vomiting center. Arch Neurol Pshychiatry 1950;63:928-41.
Sinclair, D.R., Chung F, Mezei, G. Can postoperative nausea and vomiting be predicted?. Anesthesiology, 1999;91(1):109-118.
Apfel C.C., Roewer N. Risk factors for nausea and vomiting after general anesthesia: fiction and facts. Anaesthesist, 2000;49(7):629-642.
Phenergan (promethazine HCL) injection package insert. Available from: http//www.Baxter.com/products/anesthetic-pharmaceuticals/downloads/phenerga n.pdf. Accessed October 30,2009.
Mostafavi H, Sammini M. Accidental intra-arterial injection of promethazine HCL during general anesthesia: report of a case. Anesthesiology 1971;35:645-646
Paparella S. The dangers of intravenous promethazine administration. J Emeg Nurs 2007; 33: 53-56
Keen JR, Buckley KM. Accidental intra-areterial injection: a case report, new treatment modalities, and review of literature. J Oral Maxillofacial Surg 2006;64:965-68
Hampton T. Promethazine warning. J American Medical Assoc. 2005;293(8):921
Loper KA, Ready LB, Dorman BH. Prophylactic transdermal scopolamine patches reduce nausea in postoperative patients receiving epidural morphine. Anesth Analag 1989;71:675-678.
Hookavaara P, Saarnivaara L, Klemola M. Prevention of nausea and vomiting with transdermal scopolamine in adults after middle ear surgery during general anesthesia. Br J Anaesth 1994;73:763-66.
Habib A S, Gan T J. Food and Drug administration black box warning on the perioperative use of droperidol: a review of the cases. Anesth Analg, 2003;96(5):1377-9.
Scuderi P.E. Droperidol: many questions, few answers. Anesthesiology. 2003;98(2):289-90.
Dershwitz M. Droperidol: Should the black box be light gray?. J Clin Anesth. 2002;14(8):598-603.
Droperidol.http://www.drugs.com/pro/droperidol.htlm/official FDA information, side effects and uses. Accessed October 30, 2009.
Henzi I., Walder B. Tramer M.R. Metoclopramide in the prevention of postoperative nausea and vomiting: a quantitative systemic review of randomized, placebo-controlled studies. Br J Anaesht.1999;83(5):761-71.
Sanger GJ. New antiemetic drugs. Can J Pharmaceut 1990;68:314-324.
Costall B, Naylor RJ. Neuropharmacology of emesis in relation to clinical response. Br. J cancer. 1992;66(suppl 19): S2.
Gan T J, Franiak R. Ondansetron orally disintegrating tablet versus placebo for the prevention of post discharge nausea and vomiting after ambulatory surgery. Anesth Analg. 2002;94(5):1199-200.
Tramer M.R. Efficacy, dose-response, and safety of ondasetron in prevention of postoperative nausea and vomiting: a quantitative systemic review of randomized placebo-controlled trials. Anesthesilogy. 1997.87(6):1277-89.
Dershwitz M, Conant J A, Chang Y. A randomized double blinded, dose response study of ondansetron in the prevention of postoperative nausea and vomiting. J Clin Anesth 1998;10:314-20.
Fujii Y, Tanaka H. Optimal anti-emetic dose of granisetron for prevention of post operative nausea and vomiting. Can J Anesth 1994:41:794-7.
Alon E, Buchser E. Tropisetron for treating established post operative nausea and vomiting: a randomized, double, placebo-controlled study. Anesth Analg 1998;86:617-23.
Kovac AL, Scuderi PE. Treatment of postoperative nausea and vomiting with single intravenous dose of dolasetron. Anesth Analg 1997;85:546-52.
Muchatuta N, Paech M. Management of postoperative nausea and vomiting: focus on palonosetron. Therapeutics and Clinical Risk Management. 2009;5:21-34.
Kurysher Y A. Interactions of the 5-hydroxytryptamine 3 antagonist class of antiemetics drugs with human cardiac ion channels. J Pharmacol Exp Ther. 2000 295(2):614-20.
Miller D.R. Arrhythmogenic potential of antiemetics: perspectives on risk-benefits. Can J Anasth. 2003;50(3):215-20.
Henzi I, Walder B, Tramer M. Dexamethasone for the prevention of postoperative nausea and vomiting. A quantitative systemic review. Anesth Anlg 200;90:186-94.
Unlugenc H, Guler T. Comparative study of the antiemetic efficacy of ondansetro, propofol and midazolam in the early postoperative period. Eur J Anaesthesiology 2004;21:60-65.
Cechetto DF, Diab T. The effects of propofol in the area postrema of rats. Anesth Analg 2001;92:934-42.
Greif R, Laciny S. Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiology 1999;91:1246-52.
Gesztesi Z, Scuderi PE. Substance P (Neurokinin-1) antagonist prevents postoperative vomiting after abdominal hysterectomy procedure. Anesthesiology. 2000;93(4):931-7.
Lee Ann, Done Mary. The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting. A meta-analysis. Anesth Analg.1999; 88: 1362-9.
Apfel CC. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1996;85(5):1036-42.
Gan TJ et al. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg 2003;97:62-71.
Gan TJ et al. Society of ambulatory anesthesia guidelines for the management of postoperative nausea and vomiting. Anesthesia & Analgesia. 2007;105(6):1615-162
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