Post-operative Nausea and Vomiting

Causes

• Infection

• Hypovolaemia

• Pain

• Paralytic ileus

• Drugs

Management

• Non-pharmacological

  • Minimise patient movement

  • Analgesia

  • IV fluids if dehydrated

• Pharmacological

  
  

  • 5HT-3 receptor antagonist e.g. Ondansetron is 1st line

    • Risk of constipation and QT prolongation

  • Histamine receptor antagonist e.g. Cyclizine

    • Avoid in severe HF

  • Dopamine receptor antagonist e.g. Proclorperazine

    • Risk of extrapyramidal side-effects (dystonic reactions)

      
      

  • Other anti-emetics such as corticosteroids or metoclopramide are reserved for specific cases