Overview of postoperative nausea and vomiting in adults
In adults, postoperative nausea and vomiting (PONV) occurs in 30% of patients generally, and can occur in 80% of high-risk patientsGan, 2020.
PONV causes significant patient discomfort and dissatisfaction—avoiding nausea and vomiting is a higher priority for patients than avoiding pain. PONV also prolongs recovery time, increases nursing care and cost, and delays discharge from hospitalSizemore, 2021.
Post-discharge nausea and vomiting (PDNV) occurs after a patient is discharged following ambulatory surgery. It is a major cause of unplanned hospital readmission. PDNV is problematic because patients may not have access to antiemetic therapy, particularly parenteral medication, which may be required if vomiting is severe. Patients who are at high risk of PONV are also at high risk of PDNV, and this should be taken into account when determining the patient’s antiemetic regimen.
The choice of prophylactic antiemetic regimen depends on how many risk factors for PONV (see Risk factors for postoperative nausea and vomiting in adults) are present; therefore it is important to conduct a risk-based assessment of all patients undergoing surgery.
The choice of antiemetic regimen for established PONV depends on whether prophylactic antiemetic therapy was given; see Treatment of postoperative nausea and vomiting.