Postoperative/Postdischarge Nausea & Vomiting Collection
Early Postoperative Outcomes in Children After AdenotonsillectomyChildren undergoing tonsillectomy remain at risk for postoperative pain, respiratory depression, and postoperative nausea and vomiting (PONV), presenting unique challenges for the postanesthesia nurse. This prospective, observational study examined the relationships between and factors contributing to these outcomes in 102 children after tonsillectomy. All children received an intraoperative opioid and one or more antiemetics. The majority (67%) experienced moderate to severe pain, 27% experienced a respiratory event, and 7% had PONV.
A Review of the Incidence, Causes, Consequences, and Management of Gastrointestinal Effects Associated With Postoperative Opioid AdministrationOpioid analgesics are commonly used to manage moderate to severe postoperative pain. Classic mu-opioid receptor agonists, such as morphine, meperidine, and fentanyl, provide excellent analgesia. However, their use in the postoperative setting is often limited by adverse effects such as nausea, vomiting, and reduced gastrointestinal motility. Clinicians who care for postoperative patients need to be aware of the incidences, causes, risk factors, consequences, and management of these adverse effects.
The Effects of Stimulation of Acupressure Point P6 on Postoperative Nausea and Vomiting: A Review of LiteraturePostoperative nausea and vomiting (PONV) can complicate and delay patient recovery from general and neuraxial anesthesia. Even with a new generation of anesthetic drugs and antiemetics, a high number of patients are affected by PONV. PONV has a multifactor etiology, but there are ways to reduce its occurrence. Although it is not a traditionally recognized method, stimulation of acupressure points, specifically P6, has been identified as a potentially effective method of reducing PONV. This study is a state of the science paper reviewing research on both pharmacologic and nonpharmacologic prophylaxis and various methods of acupressure.
Evidence-Based Interventions for Post Discharge Nausea and Vomiting: A Review of the LiteraturePostoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) continue to be a problem for one third of all patients who require surgery and anesthesia. Very few studies have been reported that specifically target PDNV in the outpatient surgery population for interventions after discharge home. Twenty studies were identified that specifically addressed the effect of an intervention for the purpose of preventing PDNV or rescuing the patient who develops PDNV. This article presents an integrative review of the research literature to determine the best evidence for prevention of PDNV in adults or for the rescue of patients who suffer from PDNV.
Identification of Risk Factors for Postoperative Nausea and Vomiting in the Perianesthesia Adult PatientPostoperative nausea and vomiting (PONV) is a common and potentially debilitating complication of surgery. The preoperative assessment of PONV using established risk assessment tools enables the identification of patients at risk and potentially decreases the incidence of PONV in adult surgical patients. The identification of risk factors associated with PONV and the factors that are independent predictors of PONV preoperatively can facilitate the effective prophylactic treatment and management of PONV in adult surgical patients.
Pharmacological Prophylaxis and Management of Adult Postoperative/Postdischarge Nausea and VomitingPostoperative nausea and vomiting (PONV) is a relatively common complication that can adversely affect the quality of a patient’s postoperative recovery. Factors to consider when determining a patient’s risk for developing PONV include female gender, history of PONV, history of motion sickness, nonsmoking status, postoperative use of opioids, use of inhaled anesthetic agents, and use of nitrous oxide. Receptors that, when activated, can cause PONV include dopamine type-2, serotonin type-3, histamine type-1, muscarinic cholinergic type-1, and neurokinin type-1.
Therapeutic Modalities for the Prophylactic Management of Postoperative Nausea and VomitingThe occurrence of postoperative nausea and vomiting (PONV) remains one of the most common complications after general anesthesia. The causes of PONV are multimodal, involving several physiologic pathways that stimulate the vomiting center, including the chemoreceptor trigger zone, the gastrointestinal tract, the vestibular system, the cerebral cortex, and the midbrain. Significant research has been published focusing on the use of different pharmacologic agents and varying anesthetic techniques to prevent and manage PONV.
Prevention and Management of Postoperative Nausea and Vomiting: A Look at Complementary TechniquesComplementary modalities, used alone or in combination with pharmacologic therapies, play an important role in the prevention and management of postoperative nausea and vomiting (PONV) and post discharge nausea and vomiting (PDNV). This article will review the evidence for the effective use of complementary modalities: acupuncture and related techniques, aromatherapy, and music therapy that may be integrated in the perianesthesia nurse’s plan of care to prevent or manage PONV.
Stop the Spinning World: Postoperative Nausea and VomitingIT IS 1415 on a very busy Thursday and each time one of your bay areas empties, it is rapidly refilled. You call report to Phase II, remove the monitoring equipment, and transport one of your two patients. No sooner do you return and in comes your next patient.
ASPAN’s Evidence-Based Clinical Practice Guideline for the Prevention and/or Management of PONV/PDNV Algorithms
Self-Care Activities for Postdischarge Nausea and VomitingPostdischarge nausea and vomiting (PDNV) is a serious threat to the recovery of ambulatory surgical patients. Pharmacological interventions available before discharge are not readily available to the patient after discharge; therefore, the activities that patients perform to manage new-onset PDNV may affect their surgical recovery. Assembled from a comprehensive study of PDNV, this paper describes the self-care activities that ambulatory patients use to manage new-onset nausea and vomiting after discharge.
Effect of Postoperative Supplemental Oxygen on Nausea and Vomiting After Cesarean BirthPostoperative nausea and vomiting (PONV) has a significant impact on patients and health care providers. Some nonpharmacologic methods may have an effect on PONV. Administration of supplemental oxygen (80%) during and for 2 hours after surgery has been shown to reduce the incidence of PONV from 44% to 22%. However, the effect of limiting supplemental oxygen to the immediate postoperative period on PONV is unknown. The purpose of this study was to test the efficacy of postoperative supplemental oxygen in reducing the incidence of PONV.