Postoperative Nausea and Vomiting: Risks, Prophylaxis, Non-Drug Alternative Methods

Abstract

Nausea and vomiting are among the most common complaints in the postoperative period. The type of surgical technique and the site of intervention, as well as the anesthetic drugs and methods directly contribute to the rates of postoperative nausea and vomiting (PONV). One of the most important factors affecting the frequency of postoperative nausea and vomiting is the anesthetic drugs and methods used. Many antiemetic drugs are used to prevent postoperative nausea and vomiting. With the use of these drugs, side effects especially such as delayed recovery from anesthesia, dry mouth, undesirable changes in blood pressure and the occurrence of extrapyramidal symptoms are seen. Several antiemetic drugs are commonly used for the treatment of postoperative nausea and vomiting; including scopolamine, chlorpromazine, diphenhydramine, metoclopramide, promethazine, and ondansetron. Low-dose haloperidol and metoclopramide are effective in opioid-induced nausea and vomiting. Dexamethasone reduces the incidence of postoperative nausea in the first 6 hours after surgery. Oral intake starts in patients with severe vomiting parenteral fluid and electrolyte treatment is required. Sometimes provide may need gastric decompression with nasogastric tube. Parenteral fluid and electrolyte treatment and in severe cases gastric decompression with a nasogastric tube may be necessary. Alternative medicine such as acupuncture and acupressure can help prevent or reduce postoperative nausea and vomiting. The aim of this review is to examine the medical therapies and drug-free methods used for the treatment of PONV in the light of the literatüre