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Risk Factors
The type of surgery is also known to contribute to nausea and vomiting. Minimally invasive procedures, surgeries involving the face and head, abdominal surgeries, surgeries on the urinary tract and surgeries on the reproductive organs are known to have higher rates of PONV than other procedures.
Men tend to have nausea and vomiting after surgery less than female patients, and younger patients tend to experience more than older patients. Individuals who are prone to motion sickness have much higher rates of nausea, as do non-smokers. The patient who has had prior bouts of postoperative nausea and vomiting with a previous surgery is far more likely to have it than the average patient.
A tool called the Apfel Scale is often used to determine if a patient is likely to have nausea and vomiting after surgery. There are four questions on the scale:
For each yes answer, the patient is given a point, with four being the maximum number of points. A patient with one point has a 10% chance of postoperative nausea and vomiting, a patient with four points has a 78% risk. This score will help the anesthesia provider decide if preventative medication should be given during or immediately after surgery. If you score above 2 on this scale, you may want to let your anesthesia provider know that you are at risk for nausea and vomiting after surgery.
Prevention
For some patients, the anesthesia provider will pre-medicate for nausea and vomiting, meaning that they will give anti-nausea medication before the patient has any symptoms. This is most frequently done when the patient has had a surgery that is prone to complications when vomiting occurs. For example, patients with a large abdominal incision can have a very serious complication calleddehiscence and eviscerationif prolonged vomiting occurs. The medication used to treat nausea is often more effective at preventing nausea than reducing nausea after it occurs.
Treatments
Zofran (ondansetron):This medication can be given through an IV or as a pill for the prevention or treatment of nausea and vomiting.
Phenergan(promethazine):This medication is typically given for nausea and vomiting, and can be given IV, orally as a pill or syrup, as a suppository, or as an injection into a muscle. It is known to have a side effect of sedation, making most patients sleepy.
Reglan(metoclopramide):This medication is given to increase the action of the intestines, as they are often sluggish after anesthesia, and this can result in nausea and vomiting. It is given as a pill or through an IV.
Compazine:This medication is used for multiple issues, but is known to reduce nausea and vomiting in the surgery patient. It can be given as an injection into a muscle, through an IV, as a pill or suppository. It can also reduce anxiety.
Scopolamine:This medication is used for motion sickness as well as postoperative nausea and vomiting. It can be applied as a patch, given through an IV or as an injection.
IV fluids:For some people, just being well hydrated can reduce nausea and vomiting. For others, the process of vomiting can quickly lead to dehydration. IV fluids are typically used along with a medication for the treatment of nausea and vomiting.
Nasogastric tube:For severe vomiting, a nasogastric tube may be placed into the stomach. This tube is inserted into the nose (or mouth if the patient is on a ventilator), into the esophagus and down into the stomach. The tube is attached to a suction device which gently applies suction to the tube, removing the contents of the stomach.
Frequently Asked QuestionsOral and IV medications used to treat nausea and vomiting include:CompazinePhenergan (promethazine)Reglan (metoclopramide)ScopolamineZofran (ondansetron)Both Zofran (ondansetron) and Compazine (prochlorperazine) are both medications used to treat nausea and vomiting. The two are different classes of drugs. Zofran is a selective 5-HT3 receptor antagonist. Compazine is a phenothiazine antipsychotic.Yes and no. The brand name Compazine is no longer sold in the United States. However, the drug is still available under its generic name prochlorperazine.
Frequently Asked Questions
Oral and IV medications used to treat nausea and vomiting include:CompazinePhenergan (promethazine)Reglan (metoclopramide)ScopolamineZofran (ondansetron)
Oral and IV medications used to treat nausea and vomiting include:
Both Zofran (ondansetron) and Compazine (prochlorperazine) are both medications used to treat nausea and vomiting. The two are different classes of drugs. Zofran is a selective 5-HT3 receptor antagonist. Compazine is a phenothiazine antipsychotic.
Yes and no. The brand name Compazine is no longer sold in the United States. However, the drug is still available under its generic name prochlorperazine.
3 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.Shaikh SI, Nagarekha D, Hegade G, Marutheesh M.Postoperative nausea and vomiting: A simple yet complex problem.Anesth Essays Res. 2016;10(3):388–396. doi:10.4103/0259-1162.179310Pierre S, Whelan R.Nausea and vomiting after surgery.Continuing Education in Anaesthesia Critical Care & Pain. 2013;13(1):28-32. doi:10.1093/bjaceaccp/mks046Ebell MH.Predicting postoperative nausea and vomiting.Am Fam Physician. 2007;75(10):1537-8.Additional ReadingOverview of Complications in the Post-Anesthesia Care Unit. Up to Date.
3 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.Shaikh SI, Nagarekha D, Hegade G, Marutheesh M.Postoperative nausea and vomiting: A simple yet complex problem.Anesth Essays Res. 2016;10(3):388–396. doi:10.4103/0259-1162.179310Pierre S, Whelan R.Nausea and vomiting after surgery.Continuing Education in Anaesthesia Critical Care & Pain. 2013;13(1):28-32. doi:10.1093/bjaceaccp/mks046Ebell MH.Predicting postoperative nausea and vomiting.Am Fam Physician. 2007;75(10):1537-8.Additional ReadingOverview of Complications in the Post-Anesthesia Care Unit. Up to Date.
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.
Shaikh SI, Nagarekha D, Hegade G, Marutheesh M.Postoperative nausea and vomiting: A simple yet complex problem.Anesth Essays Res. 2016;10(3):388–396. doi:10.4103/0259-1162.179310Pierre S, Whelan R.Nausea and vomiting after surgery.Continuing Education in Anaesthesia Critical Care & Pain. 2013;13(1):28-32. doi:10.1093/bjaceaccp/mks046Ebell MH.Predicting postoperative nausea and vomiting.Am Fam Physician. 2007;75(10):1537-8.
Shaikh SI, Nagarekha D, Hegade G, Marutheesh M.Postoperative nausea and vomiting: A simple yet complex problem.Anesth Essays Res. 2016;10(3):388–396. doi:10.4103/0259-1162.179310
Pierre S, Whelan R.Nausea and vomiting after surgery.Continuing Education in Anaesthesia Critical Care & Pain. 2013;13(1):28-32. doi:10.1093/bjaceaccp/mks046
Ebell MH.Predicting postoperative nausea and vomiting.Am Fam Physician. 2007;75(10):1537-8.
Overview of Complications in the Post-Anesthesia Care Unit. Up to Date.
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