PONV: Postoperative Nausea and Vomiting

PONV: Postoperative Nausea and Vomiting [1]

Postoperative nausea and vomiting (PONV) [2] is an enormous problem for patients recovering after surgery. About 30% of people experience vomiting and 50% experience nausea. As many as 80% of high-risk individuals may experience postoperative nausea and vomiting.1

Feeling nauseated after surgery is uncomfortable and can dramatically slow the return to normal activities like eating and drinking. Vomiting is more serious, as it can be very painful after surgery and can put large amounts of stress on some surgical incisions, leading to major complications like dehiscence and evisceration, dehydration, and more.

 

Surgical Risk Factors for PONV

   Abdominal surgery

   Gynecologic surgery

   Eye surgery

   Ear, nose, and throat surgery

   Breast surgery

   Any surgery lasting over 30 minutes

 

Patient Risk Factors for PONV

   Female

   Young age

   History of motion sickness

   History of prior postoperative nausea and vomiting

   Non-smoker

   Family history of PONV

 

The Efficacy of Ginger for the Prevention of Postoperative Nausea and Vomiting [3] [4][5]

According to our thorough meta-analysis ginger[6] is safe and well tolerated, and decreases the severity of PONV, and may lower the incidence of postoperative nausea and vomiting, which in turn may reduce antiemetic drug demand, suggesting that ginger may be a useful alternative to antiemetic medications to alleviate PONV [7].

 

 

Notes:
[1] Post‐Operative Nausea & Vomiting: an introduction. https://www.periopcpd.com/wp-content/uploads/PONV2.pdf
[2] Postoperative nausea and vomiting. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4188760/
[3] The Efficacy of Ginger for the Prevention of Postoperative Nausea and Vomiting: A Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/16389016/
[4] Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials https://bjanaesthesia.org/article/S0007-0912(17)38837-2/pdf
[5] The effect of ginger and metoclopramide in the prevention of nausea and vomiting during and after surgery in cesarean section under spinal anesthesia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073360/
[6] Ginger on Human Health: A Comprehensive Systematic Review of 109 Randomized Controlled Trials. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019938/
[7] Evaluation of Oral Ginger Efficacy against Postoperative Nausea and Vomiting: A Randomized, Double – Blinded Clinical Trial. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955504/