Mohammad Ashfaque.
Prevention of Postoperative Nausea And vomiting A Review of Causative Factors and Management.
Med Channel Jan ;4(1):43-52.

Two of the commonest and most distressing complications of anaesthesia and surgery are postoperative nausea and vomiting (PONV). Persistent nausea and vomiting can lead to dehydration and interfere with nutrition and oral durg therapy. Extermely forceful vomiting has resulted in dehiscence of abdominal wounds and even rupture of esophagus. The causes of postoperative nausea and vomiting are multiple, amongest which pharyngeal stimulation, gastrointestinal distention, abdominal surgery, the anaesthetic agents, pain, opioids, 11 ` hypoxia, hypotension, vestibular disturbaces and psychological factors are important. There are certain factors which can predispose patients to post-operative nausea and vomiting, these include age (more in children), sex (women more than men), obesity, prolonged fasting, recentfood intake, history of previous nausea and vomiting, history of motion sickness, long duration and depth of anaesthesia, carbon dioxide retention, rough handling, lack of skill of anaesthetist, the type of surgical procedure and number of visitors during recovery. Special difficulties are caused by vomiting in patients who have undergone day case surgery, plastic surgery, neurosurgery and head and neck surgery. Various antiemetic drugs have been tried in different studies to decrease the incidence of postoperative nausea and vomiting, but no drug has been hundred percent successful, although the incidence can be reduced.

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