Post-op nausea and vomiting is associated with high levels of patient dissatisfaction, longer admissions and therefore higher costs to the medical system.
Screen with the APFEL score + the other risk factors (younger age, type and length of surgery, anesthetic gases or nitrous exposure)
1+ risk factors? 2 prophylactic anti-emetics.
3+ risk factors? 3-4 prophylactic anti-emetics.
For rescue therapy within 6 hours post-op, use a different agent.
References:
1. Butterworth J, Mackey D, Wasnick J. Morgan & Mikhail’s Clinical Anesthesiology. 5th ed. McGraw-Hill Education; 2013.
2. Gan TJ, Belani KG, Bergese S, et al. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesth Analg. 2020;131(2):411-448. doi:10.1213/ANE.0000000000004833
3. Barash P, Cullen B, Stoelting R. Clinical Anesthesia. 8th ed. Wolters Kluwer
Have questions, comments, corrections, or concerns? Please reach out via email:
anesthesiaclerkship@gmail.com
All research, scriptwriting and recording was by Blake Birnie, MD 2021 candidate at UBC's Southern Medical School Program
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