Table of ContentsView AllTable of ContentsSymptomsComplicationsCausesTreatmentPreventionWhen to See a Provider
Table of ContentsView All
View All
Table of Contents
Symptoms
Complications
Causes
Treatment
Prevention
When to See a Provider
PONV can also cause dehydration as well as other complications such as incisional pain,esophageal rupture(a tear in the esophagus which carries food to the stomach), andwound dehiscence(the opening of the incision).
This article explains why nausea after surgery occurs along with vomiting and what can be done to prevent or treat this common postoperative condition. It also describes the signs and symptoms that warrant an immediate call to your surgeon or ER department.
Verywell / JR Bee
Common Post-Op Nausea Symptoms
PONV is a common complication that is usually not serious and typically resolves on its own or withantiemetic(anti-nausea) medication. Even so, many people rate PONV as being worse than even postoperative pain.
Studies suggest that up to 40% of people experience nausea following surgery, while roughly 30% will experience vomiting or retching (dry heaving).
DefinitionsNauseais the unpleasant, queasy sensation in which a person feels like vomiting.Vomitingis the forceful expulsion of the contents of the uppergastrointestinal tractthrough the mouth.
Definitions
Nauseais the unpleasant, queasy sensation in which a person feels like vomiting.Vomitingis the forceful expulsion of the contents of the uppergastrointestinal tractthrough the mouth.
Nauseais the unpleasant, queasy sensation in which a person feels like vomiting.
Vomitingis the forceful expulsion of the contents of the uppergastrointestinal tractthrough the mouth.
The term PONV describes nausea and/or vomiting in the post-anesthesia care unit (PACU) of a hospital or within 24 hours of undergoinginpatient surgery. Postdischarge nausea and vomiting (PDNV) refers to symptoms that occur 24 to 48 after discharge from anoutpatient surgical procedure, including dental surgery.
It can be normal for nausea to last anywhere from a few hours to a few days after surgery. However, vomiting for more than 24 hours is a cause of concern warranting immediate medical attention.
Complications of Nausea and Vomiting After Surgery
Feeling nauseous after surgery is not only uncomfortable, but it can also slow your return to normal eating and drinking. Vomiting is a more serious concern due to the rapid loss of body fluids and the physical stress it can place onincisions, particularly those around the abdomen or chest.
Possible complications of PONV include:
Complications can get progressively worse the longer PONV symptoms persist.
What to Do If a Surgical Incision Opens
Why Is Nausea Common After Surgery?
PONV is a known risk factor ofanesthesia, but certain types are more likely to cause nausea and vomiting than others. Volatile anesthesia, the type administered as a gas (such as withnitrous oxide), is 13 times more likely to cause PONV thanintravenous anesthesiadelivered into a vein (likepropofol).
The risk of PONV is also greater with certain types of surgery. These include gastrointestinal, ear, intracranial, and gynecological surgeries as well aslaparoscopic surgery(also known as “keyhole surgery.")
Contributing factors of PONV and PDNV include:
Who Is At Risk of PONV?Research suggests that you are more like to experience PONV if you are:Young to middle-agedA non-smoking femaleProne to motion sicknessOn opioid drugs
Who Is At Risk of PONV?
Research suggests that you are more like to experience PONV if you are:Young to middle-agedA non-smoking femaleProne to motion sicknessOn opioid drugs
Research suggests that you are more like to experience PONV if you are:
If a person gets PONV, medications can be prescribed to help ease the symptoms. There are also certain dietary or lifestyle modifications that can help you recover at home.
In-Hospital Care
There are a number of medications that can be used alone or in combination to treat PONV. Some directly ease nausea symptoms, while others ease contractions that contributed to vomiting.
These include:
Oral and/or intravenous fluids may be also given to treat dehydration and normalize yourelectrolyte balance.
At-Home Care
Oral medications like Zofran and Dramamine can also be prescribed if you develop PDNV. These are typically used for a couple of days until symptoms ease.
To support treatment, some studies suggest ginger (in the form of fresh ginger, ginger tea, ginger candy, or flat ginger ale) is effective in easing symptoms of PONV and PDNV.
Other experts suggest that electrolyte drinks, apple juice, and popsicles can help ease PDNV symptoms while ensuring ample hydration.
How to Treat Post-Op Nausea
With proper planning and communication, you and your medical care team can prevent nausea and vomiting after surgery.
Prophylactic Medications
If you have chronic nausea or you’ve had PONV before, you’re at risk of having it again. In such cases, your care team may prescribeprophylactic(preventative) medications such as:
Keep Hydrated
Staying hydrated before and after surgery can help prevent PONV. You need to stay away from food and non-clear liquids for safety reasons. But anesthesiologists sometimes okay clear fluids closer to the time of surgery.
Dehydration can be a problem after procedures, as well. Drinks containingelectrolytescan help hydrate you more quickly than other beverages. If you’re recovering at home, have a sports drink or Pedialyte. If you’re in the hospital, ask the nurse for something with electrolytes.
Why You Can’t Eat or Drink Before Surgery
Manage Your Pain
Don’t skip your pain medication because you’re nauseous. You may be concerned that the drugs will make you sick, but research suggests pain makes you more likely to vomit.Pain controlcan make it less likely.
Don’t Rush Your Diet
Slowly return to normal foods to minimize nausea. With some surgeries, like gastrointestinal surgeries, you don’t get to eatuntil you’re passing gas.
Be Aware of Temperature
Some people are sensitive to the temperature of fluids. If cold drinks tend to bother your stomach, ask for room-temperature or warmer drinks. If hot drinks are a problem, ask for cooler options.
Getting overheated can also make some people nauseous. If you’re feeling overly warm, do what you can to cool off.
Avoid Strong Smells
Avoid heavily scented people and places if you’re prone to nausea after anesthesia. For hospital stays, tell your care team that you are sensitive to fragrances. Ask people who may visit you to skip body sprays, perfume, and other fragranced products. You can also request foods with mild smells.
When to See a Healthcare Provider
Nausea and vomiting that occurs more than 24 hours after surgery should never be considered normal. If symptoms persist or worsen, call your surgeon or healthcare provider immediately.On the other hand, call 911 or go to your nearest emergency room if you develop the following signs and symptoms after returning home from surgery:
Ginger and Nausea
Summary
Postoperative nausea and vomiting (PONV) affect around 30% of people who undergo surgery. It is commonly associated with anesthesia, especially volatile anesthesia delivered as a gas. PONV is more common with digestive, gynecological, ear, intracranial, or laparoscopic surgeries, or with surgeries that last longer than 30 minutes.
Preventive medications may be prescribed for people at risk of PONV. For people who develop PONV, anti-nausea drugs can help ease symptoms. If left untreated, PONV may lead to severe dehydration, esophageal bleeding, and surgical site complications such as infection, prolonged healing, or reopening of the incision.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Amirshahi M, Behnamfar N, Badakhsh M, Rafiemanesh H, Keikhaie KR, Sheyback M, Sari M.Prevalence of postoperative nausea and vomiting: A systematic review and meta-analysis.Saudi J Anaesth. 2020 Jan-Mar;14(1):48-56. doi:10.4103/sja.SJA_401_19Choi SU.Is postoperative nausea and vomiting still the big “little” problem?.Korean J Anesthesiol. 2016 Feb;69(1):1-2. doi:10.4097/kjae.2016.69.1.1National Library of Medicine.Esophageal Perforation and Tears.Shaikh SI, Nagarekha D, Hegade G, Marutheesh M.Postoperative nausea and vomiting: a simple yet complex problem.Anesth Essays Res. 2016;10(3):388–96. doi:10.4103/0259-1162.179310Johansson E, Hultin M, Myrberg T, Walldén J.Early post‐operative nausea and vomiting: A retrospective observational study of 2030 patients.Acta Anaesthesiol Scand. 2021 Oct;65(9):1229–39. doi:10.1111/aas.13936Gan TJ, Diemunsch P, Habib AS, et al.Consensus guidelines for the management of postoperative nausea and vomiting.Anesth Analg. 2014;118(1):85-113. doi:10.1213/ANE.0000000000000002American Society of Anesthesiologists.Effects of anesthesia.Hasegawa H, Abe A, Hayashi H, Furuta H, Ishihama T.Risk factors for postoperative nausea and vomiting after the removal of impacted third molars: a cross-sectional study.BMC Oral Health. 2021 Mar 16;21(1):121. doi:10.1186/s12903-021-01481-8Moreno C, Veiga D, Pereira H, Martinho C, Abelha F.Postoperative nausea and vomiting: incidence, characteristics and risk factors–a prospective cohort study.Rev Esp Anestesiol Reanim. 2013;60(5):249-56. doi:10.1016/j.redar.2013.02.005Tóth B, Lantos T, Hegyi P, et al.Ginger (Zingiber officinale): An alternative for the prevention of postoperative nausea and vomiting. A meta-analysis.Phytomedicine. 2018;50:8-18. doi:10.1016/j.phymed.2018.09.007American Nursing Association.Putting a stop to postop nausea and vomiting.Yavuz MS, Kazancı D, Turan S, et al.Investigation of the effects of preoperative hydration on the postoperative nausea and vomiting.Biomed Res Int. 2014;2014:302747. doi:10.1155/2014/302747Additional ReadingAmerican Nurse.Putting a stop to postop nausea and vomiting.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Amirshahi M, Behnamfar N, Badakhsh M, Rafiemanesh H, Keikhaie KR, Sheyback M, Sari M.Prevalence of postoperative nausea and vomiting: A systematic review and meta-analysis.Saudi J Anaesth. 2020 Jan-Mar;14(1):48-56. doi:10.4103/sja.SJA_401_19Choi SU.Is postoperative nausea and vomiting still the big “little” problem?.Korean J Anesthesiol. 2016 Feb;69(1):1-2. doi:10.4097/kjae.2016.69.1.1National Library of Medicine.Esophageal Perforation and Tears.Shaikh SI, Nagarekha D, Hegade G, Marutheesh M.Postoperative nausea and vomiting: a simple yet complex problem.Anesth Essays Res. 2016;10(3):388–96. doi:10.4103/0259-1162.179310Johansson E, Hultin M, Myrberg T, Walldén J.Early post‐operative nausea and vomiting: A retrospective observational study of 2030 patients.Acta Anaesthesiol Scand. 2021 Oct;65(9):1229–39. doi:10.1111/aas.13936Gan TJ, Diemunsch P, Habib AS, et al.Consensus guidelines for the management of postoperative nausea and vomiting.Anesth Analg. 2014;118(1):85-113. doi:10.1213/ANE.0000000000000002American Society of Anesthesiologists.Effects of anesthesia.Hasegawa H, Abe A, Hayashi H, Furuta H, Ishihama T.Risk factors for postoperative nausea and vomiting after the removal of impacted third molars: a cross-sectional study.BMC Oral Health. 2021 Mar 16;21(1):121. doi:10.1186/s12903-021-01481-8Moreno C, Veiga D, Pereira H, Martinho C, Abelha F.Postoperative nausea and vomiting: incidence, characteristics and risk factors–a prospective cohort study.Rev Esp Anestesiol Reanim. 2013;60(5):249-56. doi:10.1016/j.redar.2013.02.005Tóth B, Lantos T, Hegyi P, et al.Ginger (Zingiber officinale): An alternative for the prevention of postoperative nausea and vomiting. A meta-analysis.Phytomedicine. 2018;50:8-18. doi:10.1016/j.phymed.2018.09.007American Nursing Association.Putting a stop to postop nausea and vomiting.Yavuz MS, Kazancı D, Turan S, et al.Investigation of the effects of preoperative hydration on the postoperative nausea and vomiting.Biomed Res Int. 2014;2014:302747. doi:10.1155/2014/302747Additional ReadingAmerican Nurse.Putting a stop to postop nausea and vomiting.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Amirshahi M, Behnamfar N, Badakhsh M, Rafiemanesh H, Keikhaie KR, Sheyback M, Sari M.Prevalence of postoperative nausea and vomiting: A systematic review and meta-analysis.Saudi J Anaesth. 2020 Jan-Mar;14(1):48-56. doi:10.4103/sja.SJA_401_19Choi SU.Is postoperative nausea and vomiting still the big “little” problem?.Korean J Anesthesiol. 2016 Feb;69(1):1-2. doi:10.4097/kjae.2016.69.1.1National Library of Medicine.Esophageal Perforation and Tears.Shaikh SI, Nagarekha D, Hegade G, Marutheesh M.Postoperative nausea and vomiting: a simple yet complex problem.Anesth Essays Res. 2016;10(3):388–96. doi:10.4103/0259-1162.179310Johansson E, Hultin M, Myrberg T, Walldén J.Early post‐operative nausea and vomiting: A retrospective observational study of 2030 patients.Acta Anaesthesiol Scand. 2021 Oct;65(9):1229–39. doi:10.1111/aas.13936Gan TJ, Diemunsch P, Habib AS, et al.Consensus guidelines for the management of postoperative nausea and vomiting.Anesth Analg. 2014;118(1):85-113. doi:10.1213/ANE.0000000000000002American Society of Anesthesiologists.Effects of anesthesia.Hasegawa H, Abe A, Hayashi H, Furuta H, Ishihama T.Risk factors for postoperative nausea and vomiting after the removal of impacted third molars: a cross-sectional study.BMC Oral Health. 2021 Mar 16;21(1):121. doi:10.1186/s12903-021-01481-8Moreno C, Veiga D, Pereira H, Martinho C, Abelha F.Postoperative nausea and vomiting: incidence, characteristics and risk factors–a prospective cohort study.Rev Esp Anestesiol Reanim. 2013;60(5):249-56. doi:10.1016/j.redar.2013.02.005Tóth B, Lantos T, Hegyi P, et al.Ginger (Zingiber officinale): An alternative for the prevention of postoperative nausea and vomiting. A meta-analysis.Phytomedicine. 2018;50:8-18. doi:10.1016/j.phymed.2018.09.007American Nursing Association.Putting a stop to postop nausea and vomiting.Yavuz MS, Kazancı D, Turan S, et al.Investigation of the effects of preoperative hydration on the postoperative nausea and vomiting.Biomed Res Int. 2014;2014:302747. doi:10.1155/2014/302747
Amirshahi M, Behnamfar N, Badakhsh M, Rafiemanesh H, Keikhaie KR, Sheyback M, Sari M.Prevalence of postoperative nausea and vomiting: A systematic review and meta-analysis.Saudi J Anaesth. 2020 Jan-Mar;14(1):48-56. doi:10.4103/sja.SJA_401_19
Choi SU.Is postoperative nausea and vomiting still the big “little” problem?.Korean J Anesthesiol. 2016 Feb;69(1):1-2. doi:10.4097/kjae.2016.69.1.1
National Library of Medicine.Esophageal Perforation and Tears.
Shaikh SI, Nagarekha D, Hegade G, Marutheesh M.Postoperative nausea and vomiting: a simple yet complex problem.Anesth Essays Res. 2016;10(3):388–96. doi:10.4103/0259-1162.179310
Johansson E, Hultin M, Myrberg T, Walldén J.Early post‐operative nausea and vomiting: A retrospective observational study of 2030 patients.Acta Anaesthesiol Scand. 2021 Oct;65(9):1229–39. doi:10.1111/aas.13936
Gan TJ, Diemunsch P, Habib AS, et al.Consensus guidelines for the management of postoperative nausea and vomiting.Anesth Analg. 2014;118(1):85-113. doi:10.1213/ANE.0000000000000002
American Society of Anesthesiologists.Effects of anesthesia.
Hasegawa H, Abe A, Hayashi H, Furuta H, Ishihama T.Risk factors for postoperative nausea and vomiting after the removal of impacted third molars: a cross-sectional study.BMC Oral Health. 2021 Mar 16;21(1):121. doi:10.1186/s12903-021-01481-8
Moreno C, Veiga D, Pereira H, Martinho C, Abelha F.Postoperative nausea and vomiting: incidence, characteristics and risk factors–a prospective cohort study.Rev Esp Anestesiol Reanim. 2013;60(5):249-56. doi:10.1016/j.redar.2013.02.005
Tóth B, Lantos T, Hegyi P, et al.Ginger (Zingiber officinale): An alternative for the prevention of postoperative nausea and vomiting. A meta-analysis.Phytomedicine. 2018;50:8-18. doi:10.1016/j.phymed.2018.09.007
American Nursing Association.Putting a stop to postop nausea and vomiting.
Yavuz MS, Kazancı D, Turan S, et al.Investigation of the effects of preoperative hydration on the postoperative nausea and vomiting.Biomed Res Int. 2014;2014:302747. doi:10.1155/2014/302747
American Nurse.Putting a stop to postop nausea and vomiting.
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