Current Concepts in the Management of Postoperative Nausea and Vomiting

Table 1

Anaesthetic strategies to decrease PONV.

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(1) Use of regional anaesthesia.

(2) Avoid emetogenic stimuli

 (a) Nitrous oxide

 (b) Inhalational agents

 (c) Etomidate and Ketamine.

(3) Minimize the following:

 (a) Intraoperative and postoperative opioids

 (b) Adequate analgesia incorporating local anaesthetics, NSAIDs, and opioid as required

 (c) Limiting the dose of neostigmine to 2.5 mg in adults.

(4) To consider the following:

 (a) Total intravenous anaesthesia (TIVA) with propofol

 (b) Adequate hydration, especially with colloids.

 (c) Use of intraoperative supplemental oxygen

 (d) Use of a anxiolytics, for example, benzodiazepines

 (e) Nonpharmacological techniques, for example, acupuncture.

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