NDLI: Multimodal therapies for postoperative nausea and vomiting, and pain.

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The 2011 BJA/PGA supplement: a selection of nine educational reviews.

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Multimodal therapies for postoperative nausea and vomiting, and pain.

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Perioperative management of the paediatric patient with coexisting neuromuscular disease.

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Regional anaesthesia in the patient receiving antithrombotic and antiplatelet therapy.

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Multimodal therapies for postoperative nausea and vomiting, and pain.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Chandrakantan, A. Glass, P. S. A.
Description	Country affiliation: United States Author Affiliation: Chandrakantan A ( Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, USA. arvind.chandrakantan@stonybrook.edu)
Abstract	Postoperative nausea and vomiting (PONV) and pain are two of the major concerns for patients presenting for surgery. The causes of PONV are multifactorial and can largely be categorized as patient risk factors, anaesthetic technique, and surgical procedure. Antiemetics work on several different receptor sites to prevent or treat PONV. This is probably why numerous studies have now demonstrated that using more than one antiemetic is usually more effective and results in fewer side-effects than simply increasing the dose of a single antiemetic. A multimodal approach to PONV should not be limited to drug therapy alone but should involve a holistic approach starting before operation and continuing intraoperatively with risk reduction strategies to which are added prophylactic antiemetics according to the assessed patient risk for PONV. With the increasing understanding of the pathophysiology of acute pain, especially the occurrence of peripheral and central hypersensitization, it is unlikely that a single drug or intervention is sufficiently broad in its action to be adequately effective, especially with moderate or greater pain. Although morphine and its congeners are usually the foundation of pain management regimens, as their dose increases so does the incidence of side-effects. Thus, the approach for the management of acute postoperative pain is to use multiple drugs or modalities (e.g. regional anaesthesia) to maximize pain relief and reduce side-effects.
File Format	HTM / HTML
ISSN	00070912
e-ISSN	14716771
Journal	British Journal of Anaesthesia
Issue Number	Suppl 1
Volume Number	107
Language	English
Publisher	Oxford University Press
Publisher Date	2011-12-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Anesthesiology Pain Management Pain, Postoperative Therapy Postoperative Nausea And Vomiting Anesthesia, Conduction Antiemetics Therapeutic Use Child, Preschool Combined Modality Therapy Physiopathology Risk Factors
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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