30-50% of patients undergoing surgery in the general population experience post-operative nausea and vomiting (PONV), increasing to 70-80% in patients with additional risk factors for having PONV (Murakami et. al, 2017). PONV can lead to a host of other complications.
Despite pharmacologic protocols, PONV remains prevalent. Non-pharmacologic interventions as an adjunct could potentially save time and costs and be an easy, nurse-driven response in treating PONV. I’ll be using Orem’s Self-Care Deficit Theory as a theoretical framework.
Murakami, C., Kakuta, N., Kume, K., Sakai, Y., Kasai, A., Oyama, T., Tanaka, K., & Tsutsumi, Y. M. (2017). A Comparison of Fosaprepitant and Ondansetron for Preventing Postoperative Nausea and Vomiting in Moderate to High Risk Patients: A Retrospective Database Analysis. BioMed Research International, 2017, 1–5. https://doiorg.ezproxy.fhsu.edu/10.1155/2017/5703528
Postoperative nausea and vomiting is a challenging problem. Postoperative nausea and vomiting is the second common complaint with pain being the most common (Shaikh et al., 2016). Patient factors that influence PONV inlcude gender – women are more likely to experience PONV than men. It is the strongest patient-specific predictor (Shaikh et al., 2016). Patients with a history of motion sickness or vomiting after previous surgery are at increased risk of PONV (Shaikh et al., 2016). Non-smokers are more prone to PONV as well as people less than 50 years of age (Shaikh et al., 2016). How does pain, ambulation, or opioids affect PONV? Your post is very informative. Good job.
Shaikh, S. I., Nagarekha, D., Hegade, G., & Marutheesh, M. (2016). Postoperative nausea and vomiting: a simple yet complex problem. Anesthesia Essays and Researches, 10(3), 388-396.
Thank you. I think opioids are a big problem for PONV. The TAP block procedure mentioned decreases need for opiates for pain relief and in turn can help to prevent PONV. Opiates can trigger the nausea center in the brain.
PONV is a significant issue that I believe needs a lot more work. I thoroughly enjoyed reading the information on your poster and the alternative anti-emetic studies that have been carried out. I struggle with terrible nausea post anesthesia and do not do well tolerating narcotics for pain control. I let my doctor know this prior to my tonsillectomy, and they provided a prescription for Zofran that I could take prior to taking my medications as well as IV Zofran prior to my procedure. I do believe there are benefits to the non-pharmacological methods discussed, but it’s good to know that there is also pharmacological stuff that can help when other methods fail.