Post-Operative Nausea and Vomiting

#2: Post-Operative Nausea and Vomiting (PONV)

One of the most dreaded side-effects of general anesthesia is nausea followed by vomiting. It’s such a frequent side-effect that it has its own name: post-operative nausea and vomiting, or PONV. The nausea is triggered in some way by how the anesthesia effects the brain centers and the gastrointestinal system.

Patients with the following characteristics are more prone to post-operative nausea and vomiting or PONV.

• Female,
• Young,
• Non-smoking,
• A history of motion sickness,
• A personal or family history of PONV.,

Surgeries more likely to lead to PONV include:,

• Any surgery lasting longer than 30 minutes,
• Abdominal and gynecological surgeries,
• Ear, nose and throat surgeries,,
• Laparoscopic surgeries,
• Breast surgery
• Eye surgery
• Some orthopedic surgery

This list would appear to include almost every kind of surgery. Even in the few kinds of surgery not included, there are additional, unavoidable factors such as the such as use of narcotic and gas medications that contribute to PONV. So if we can't change many of these risk factors what can we do about PONV?

How to Prevent Post-Operative Nausea and Vomiting

Patients

• Talk with your doctors. Follow pre-op instructions about not eating and tell your anesthesiologist or the pre-op nurse about your risk factors (they will probably ask anyway). Also be sure to follow post-op instructions to the letter.
• Acupressure relief bands. Some people say they have been helped by the accupressure relief bands that are sold over the counter. Bring one with you and ask that it be applied as soon as it is safe (usually after surgery, but sometimes before).
• Start slow and go easy. When you get home, even if you feel hungry, start slowly with eating. start with soft, easy to digest foods. Eat little bits at a time and wait to see how you feel before moving on to harder-to-digest meals.
• Liquid diet. Some people prefer to stay on liquid diets for the first day after anesthesia, and if you have had abdominal or gastrointestinal surgery, your diet will be restricted as ordered by your surgeon and advanced at their discretion.
• Ginger. The herb is often recommended as another over-the-counter nausea reliever. Follow your postop instructions, as well.

Anesthesiologists

• Preventative medications. We can give prophylactic (preventative) medications to help reduce the risk of PONV. There are various drugs we can give alone or in combination, based on the level of risk and the risk/benefit ratio of each drug, because, yes, they have side effects too. Sometimes, we can alter the type of anesthetic or the medications used if the risk is significant.
• Hydration. We also try to make sure you are properly hydrated, especially if you have gone a long period of time before your surgery without liquids.

Surgeons

Surgeons need to get the surgery done and cannot make significant alterations in procedure to avoid nausea and vomiting.

• Anti-nausea medication. Surgeons can, at your request, prescribe an anti-nausea medicine along with the pain medicine that you will be taking. If you are prone to nausea and vomiting from the anesthetic, there is a good chance that the narcotic pain meds will make you sick, as well. So ask your surgeon in pre-op (before you are too out of it to remember) to prescribe the anti-nausea medicine.

#3: Confusion

When coming out of anesthesia in the recovery, most people experience a profound sense of confusion and disorientation. It takes a while for the brain to actually wake up, even after you are conscious. Most people don't remember much after the pre-op sedative has been given.

However, some people remain confused for days or weeks, or longer after their surgery and anesthetic. This is an active field of study right now, called Post-Operative Cognitive Dysfunction (POCD). One interesting thing to note, is that this effect doesn’t just occur with general anesthesia. Indeed, even patients who had other types of anesthesia that should not affect the brain profoundly have experienced POCD. It seems that other factors, such as the stresses of surgery and recovery on the body may also play a role.

We only know at this point that older patients and patients of lower socio-economic status have a higher risk for POCD. Active and diligent research continues to try to pinpoint who is at risk, why it occurs and what, if anything, can be done to prevent it.

Share on Google Plus

About Anjum insurance

This is a short description in the author block about the author. You edit it by entering text in the "Biographical Info" field in the user admin panel.