Postoperative nausea and vomiting

Abstract

Abstract Postoperative nausea and vomiting (PONV) is a prevalent side effect following general anaesthetic and surgery. Areas of the brainstem that coordinate the process of vomiting receive inputs from a number of areas, including high cortical areas and, importantly, the chemoreceptor trigger zone of the area postrema in the medulla oblongata of the brainstem, which can be affected directly by anaesthetic agents. A number of risk factors for PONV have been identified, and scores developed to help stratify risk. Based on this stratified risk pharmacological therapy can be given prophylactically intraoperatively, or as rescue postoperatively. The mechanisms and side effects of these drugs is discussed alongside a recent review of efficacy, and some potential future developments.