Vomiting postoperative

Other Uses in Geriatric Patient Diabetic gastroparesis. Chemotherapy-induced nausea and vomiting. Postoperative nausea and vomiting... 

Several histamine receptor antagonists are effective in treating motion sickness, Meniere s disease, morning sickness, uraemia and postoperative vomiting. They are not effective against cytotoxics. Antagonists with... 

These include atropine, scopolamine (hyoscine), trihexyphenidyl (benzhexol) and benzatropine. They block central muscarinic receptors involved in various afferent pathways of the vomiting reflex (Fig. 1). They have been used to control motion sickness, emesis in Meniere s disease and postoperative vomiting. Currently, hyoscine is largely restricted to the treatment of motion sickness where it has a fast onset of action but a short duration (4-6 h). Administration of hyoscine by transdermal patch produces a prolonged, low-level release of the drug with minimal side effects. To control postoperative vomiting, it should be applied >8 h before emesis is anticipated. 

Gan TJ, Meyer T, Apfel CC et al (2003) Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg 97 62-71... 

Wallenborn J, Gelbrich G, Bulst D et al (2006) Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone randomised double blind multicentre trial. Br Med J 333 324-327... 

Antiemetic—to lessen the incidence of nausea and vomiting during the immediate postoperative recovery period. 

Droperidol or a 5-HT3 receptor antagonist should be administered at the end of surgery to patients at high risk for developing postoperative nausea and vomiting. 

CINV, chemotherapy-induced nausea and vomiting PONV, postoperative nausea and vomiting. 

Gan TJ, Meyer T, Apfel CC, et al. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg 2003 97 62-71. Gralla RJ, Osoba D, Kris MG, et al. Recommendations for the use of antiemetics evidence based clinical practice guidelines. J Clin Oncol 1999 17 2971-2994. 

Ondansetron Postoperative vomiting and vomiting associated with cancer chemotherapy... 

Dexamethasone has been used successfully in the management of chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV), either as a single agent or in combination with selective serotonin reuptake inhibitors (SSRIs). For CINV, dexamethasone is effective in the prevention of both cisplatin-induced acute emesis and when used alone or in combination for the prevention of delayed nausea and vomiting associated with CINV. 

Arfeen Z, Owen H, Plummer JL, Ilsley AH, Sorby-Adams RA, Doecke G. (1995). A double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting. Anaesth Intensive Care. 23(4) 449-52. 

Bone ME, Wilkinson DJ, Young JR, McNeil J, Charlton S. (1990). Ginger root—a new antiemetic. The effect of ginger root on postoperative nausea and vomiting after major gynaecological surgery. Anaesthesia. 45(8) 669-71. 

Koivuranta M, Laara E, Ranta P, Ravaska P, Alahuhta S. (1997). Comparison of ondansetron and droperidol in the prevention of postoperative nausea and vomiting after laparoscopic surgery in women. A randomised, double-blind, placebo-controlled trial. Acta Anaesthesiol Scand. 41(10) 1273-9. 

Visalyaputra S, Petchpaisit N, Somcharoen K, Choavaratana R. (1998). The efficacy of ginger root in the prevention of postoperative nausea and vomiting after outpatient gynaecological laparoscopy. Anaesthesia. 53(5) 506-10. 

Ondansetron is a 5HT3 antagonist, blocking serotonin receptors in the central nervous system and the gastrointestinal tract. It is useful in the management of postoperative nausea and vomiting associated with cytotoxics. 

Metoclopramide is ineffective in motion sickness, as it acts selectively on the chemoreceptor trigger zone. Metoclopramide is effective in treating vomiting associated with gastroduodenal, biliary and hepatic disease, and postoperative vomiting. 

Adverse reactions occurring in at least 3% of patients include nausea vomiting tachycardia hypertension postoperative pain fever dizziness. 

Promethazine Promethazine also is indicated for preoperative, postoperative, or obstetric sedation prevention and control of nausea and vomiting associated with certain types of anesthesia and surgery an adjunct to analgesics for control of postoperative pain sedation and relief of apprehension, and to produce light sleep antiemetic effect in postoperative patients active and prophylactic treatment of motion sickness (oral and rectal only). 

Nausea and vomiting 12.5 to 25 mg do not repeat more frequently than every 4 hours. For postoperative nausea and vomiting, administer IM or IV. 

---