ABSTRACT
Postoperative nausea and vomiting (PONV) persists, both as a problem for patients and as a thorn in the anesthetist’s flesh. Despite recent pharmacologic advances in antiemetic therapy, little has been achieved in altering the frequency of this complaint. The overall incidence remains at 20% to 30%, yet may be as high as 70% for high-risk patients undergoing major intra-abdominal surgery (1,2). Nausea and vomiting are rated among the most unpleasant perioperative experiences, and commonly account for poor patient satisfaction. In one survey of a schedule of undesirable postoperative outcomes, vomiting ranked supreme (incisional pain third and nausea fourth) (3). PONV causes prolonged postanesthesia care unit (PACU) stay, contributes directly to delayed hospital discharge, and augments medical expenditure. These components stress on ambulatory centers where emphasis rests on early mobilization after minor as well as major surgery.
