NDLI: Management of postdischarge nausea and vomiting after ambulatory surgery.

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Management of postdischarge nausea and vomiting after ambulatory surgery.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Melton, M. Stephen Klein, Stephen M. Gan, Tong J.
Description	Country affiliation: United States Author Affiliation: Melton MS ( Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA.)
Abstract	PURPOSE OF REVIEW: Although there are extensive studies of postoperative and postdischarge nausea and vomiting (PONV/PDNV) up to 24â h, few investigate 'delayed PDNV'. With an increasing outpatient surgical population, specific 'delayed PDNV' risk identification and management is necessary for improving outcomes and helping patients after discharge. This review will discuss possible PDNV specific risk factors, successful prevention and management of PDNV following ambulatory anesthesia and the principles and pharmacology of these interventions. RECENT FINDINGS: Current research has demonstrated beneficial PDNV management up to 72 â h with the long-acting 5-hydroxytryptamine-3 receptor antagonist palonosetron. Neurokinin-1 antagonists have demonstrated superior antiemesis, but not antinausea compared with more traditional and less expensive options. Dexamethasone provides improvements in quality of recovery associated with improved PDNV outcomes. SUMMARY: Further PDNV specific research is needed, including PDNV predictive models in directing antiemetic interventions. Long-acting antiemetics and postdischarge oral antiemetics are effective in PDNV pharmacologic management. Neurokinin-1 receptor antagonists are effective in reducing the incidence of vomiting, but not nausea. The addition of nonpharmacologic interventions such as acustimulation may reduce PDNV. Multimodal analgesia including nonopioid analgesics and ambulatory continuous peripheral nerve blocks are encouraged to achieve adequate postoperative analgesia and reduce opioid induced PDNV.
File Format	HTM / HTML
ISSN	09527907
Issue Number	6
Volume Number	24
e-ISSN	14736500
Journal	Current Opinion in Anaesthesiology
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2011-12-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Ambulatory Surgical Procedures Anesthesia Adverse Effects Antiemetics Therapeutic Use Patient Discharge Postoperative Nausea And Vomiting Drug Therapy Cholinergic Antagonists Combined Modality Therapy Dexamethasone Glucocorticoids Humans Isoquinolines Neurokinin-1 Receptor Antagonists Prevention & Control Quinuclidines Risk Factors Serotonin Antagonists Journal Article Review
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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