Abstract
Postoperative nausea and vomiting (PONV) is among the most important concerns of patients undergoing surgery. The incidence ranges from 30% to 70%. The incidence of PONV correlates with a number of risk factors a patient possesses. Patient-related risk factors in adults are: female gender, history of PONV, duration of surgery > 60 min, nonsmoking status, history of motion sickness, and postoperative use of opioids. Risk factors in children are: duration of surgery � 30 minutes, age � 3 years, strabismus surgery, and a history of PONV in the patient, parent or sibling. Treatment of PONV includes various classes of medications and none of them is entirely effective. If it is necessary to use combination therapy, then medicines with different sites of activity should be used. Promethazine is a phenothiazine derivate available as a medicine since its introduction in 1946. In this article, a search was performed to identify all published papers and reports evaluating the effectiveness of promethazine for the management of postoperative nausea and vomiting in adults and children. The results of this review support the finding that promethazine is not recommended as a first-line agent in the treatment of PONV, but can be considered for use as a rescue antiemetic.
Highlights
Postoperative nausea and vomiting (PONV), together with pain, is among the most important concerns of patients undergoing surgery
It is evident from tables 1 and 2 that despite its widespread use, little data evaluating the therapeutic efficacy of promethazine is available
There are more articles evaluating efficacy of other antiemetics, but evaluation of these treatments was beyond the scope of this review
Summary
Postoperative nausea and vomiting (PONV), together with pain, is among the most important concerns of patients undergoing surgery. [3, 4] Patients who experience PONV require additional health care. Nausea, vomiting and retching can occur with all types of anesthesia (general, regional or local). All of this may delay discharge from the postanesthesia care unit (PACU) or require additional medical interventions, resulting in increased health care costs. This article will review the therapeutic efficacy of promethazine in the treatment of postoperative nausea and vomiting
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