SAMBA Consensus Guidelines for the Management of Postoperative Nausea and Vomiting: An Executive Summary for Perianesthesia Nurses

Abstract

POSTOPERATIVE NAUSEA AND VOMITING (PONV) remains one of the most common, and most distressing postoperative complications. Despite advances in pharmacological and nonpharmacological prophylactic and rescue interventions, postoperative vomiting (POV) occurs in approximately 30% of surgical patients, while the incidence of nausea is around 50%. The incidence of PONV in high risk patients may run as high as 80%. 1 Gan T.J. Diemunsch P. Habib A.S. et al. Consensus guidelines for the management of postoperative nausea and vomiting. [Erratum appears in Anesth Analg. 2014 Mar;118(3):689]. Anesth Analg. 2014; 118: 85-113 Crossref PubMed Scopus (920) Google Scholar , 2 Kapur P.A. Editorial: The Big “Little Problem”. Anesth Analg. 1991; 73: 243-245 Crossref PubMed Google Scholar , 3 Odom-Forren J. Hooper V. Moser D.K. et al. Postdischarge Nausea and Vomiting: Management Strategies and Outcomes Over 7 Days. J Perianesth Nurs. 2013; 29: 275-284 Abstract Full Text Full Text PDF Scopus (22) Google Scholar , 4 Odom-Forren J. Jalota L. Moser D.K. et al. Incidence and predictors of postdischarge nausea and vomiting in a 7-day population. J Clin Anesth. 2013; 25: 551-559 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar , 5 Samuels J.D. Perioperative nausea and vomiting: much ado about nothing?. Aesthetic Plast Surg. 2013; 37: 634-635 Crossref PubMed Scopus (3) Google Scholar , 6 Sussanne B. Arwestrom C. Baker A. Bertero C. Nurses’ experiences in the relief of postoperative nausea and vomiting. J Clin Nurs. 2010; 19: 1865-1872 Crossref PubMed Scopus (8) Google Scholar Although relatively short-lived in nature, patients identify PONV as one of the most dreaded postoperative complications, many fearing PONV more than postoperative pain. 1 Gan T.J. Diemunsch P. Habib A.S. et al. Consensus guidelines for the management of postoperative nausea and vomiting. [Erratum appears in Anesth Analg. 2014 Mar;118(3):689]. Anesth Analg. 2014; 118: 85-113 Crossref PubMed Scopus (920) Google Scholar , 2 Kapur P.A. Editorial: The Big “Little Problem”. Anesth Analg. 1991; 73: 243-245 Crossref PubMed Google Scholar , 5 Samuels J.D. Perioperative nausea and vomiting: much ado about nothing?. Aesthetic Plast Surg. 2013; 37: 634-635 Crossref PubMed Scopus (3) Google Scholar Protracted PONV is associated with increased cost of care, most commonly related to extended PACU length of stay (LOS) and increased unplanned hospital admissions. Unrelieved postdischarge nausea and vomiting (PDNV) has been associated with delayed return to work/normal activities of daily living, and often contributes to emergency department visits and associated hospital readmission. 1 Gan T.J. Diemunsch P. Habib A.S. et al. Consensus guidelines for the management of postoperative nausea and vomiting. [Erratum appears in Anesth Analg. 2014 Mar;118(3):689]. Anesth Analg. 2014; 118: 85-113 Crossref PubMed Scopus (920) Google Scholar , 3 Odom-Forren J. Hooper V. Moser D.K. et al. Postdischarge Nausea and Vomiting: Management Strategies and Outcomes Over 7 Days. J Perianesth Nurs. 2013; 29: 275-284 Abstract Full Text Full Text PDF Scopus (22) Google Scholar , 4 Odom-Forren J. Jalota L. Moser D.K. et al. Incidence and predictors of postdischarge nausea and vomiting in a 7-day population. J Clin Anesth. 2013; 25: 551-559 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar Vallire D. Hooper, PhD, RN, CPAN, FAAN, is a Manager, Nursing Research, Mission Hospital, Asheville, NC