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Postoperative Nausea and Vomiting (PONV)

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Emesis and queasiness occurring after anesthesia.

Also Known As:

PONV; Emesis, Postoperative; Nausea, Postoperative; Postoperative Emesis; Postoperative Nausea; Postoperative Vomiting; Vomiting, Postoperative; Emeses, Postoperative; Postoperative Emeses; Nausea and Vomiting, Postoperative

Networked: 2657 relevant articles (611 outcomes, 682 trials/studies)

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Disease Context: Research Results

Signs and Symptoms Pathological Conditions
- Pathologic Processes: 4357
  - Postoperative Complications
    - Postoperative Nausea and Vomiting: 2657
- Signs and Symptoms
  - Digestive Signs and Symptoms
    - Vomiting: 16422
      - Postoperative Nausea and Vomiting: 2657
    - Nausea: 15092
      - Postoperative Nausea and Vomiting: 2657

Related Diseases

1.	Postoperative Nausea and Vomiting (PONV)
2.	Vomiting
3.	Nausea
4.	Strabismus (Squint)
5.	Pain (Aches)

Experts

1.	Gan, Tong J: 43 articles (12/2014 - 05/2002)
2.	Fujii, Yoshitaka: 31 articles (12/2011 - 01/2002)
3.	Habib, Ashraf S: 25 articles (11/2015 - 04/2003)
4.	Kranke, Peter: 21 articles (05/2015 - 07/2002)
5.	Apfel, Christian C: 20 articles (01/2014 - 12/2003)
6.	Fujii, Y: 20 articles (03/2010 - 01/2000)
7.	Kranke, P: 18 articles (03/2015 - 04/2000)
8.	Apfel, C C: 16 articles (07/2015 - 04/2000)
9.	Tramèr, Martin R: 12 articles (06/2014 - 01/2003)
10.	White, Paul F: 12 articles (07/2012 - 06/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Postoperative Nausea and Vomiting:

1.	Ondansetron (Zofran)FDA LinkGeneric 01/01/1994 - "In conclusion ondansetron given preoperatively had proven to be an effective treatment for PONV after epidural block for lower abdominal surgery." 02/01/1994 - "Clearance has been received from the Food and Drug Administration for marketing of Zofran injection for the prevention of postoperative nausea and vomiting, at a dose of 4 mg IV over 2 to 5 min. Zofran has been evaluated in clinical studies with good results in the reduction or prevention of postoperative nausea and vomiting with minimal adverse reactions." 12/01/1999 - "We evaluated the antiemetic efficacy, safety, and routine use of prophylactic ondansetron, a "gold standard" antiemetic, in women undergoing radical breast surgery who were at a high risk of postoperative vomiting. " 01/01/1999 - "Ondansetron, a selective serotonergic antagonist, is effective in reducing postoperative nausea and vomiting in several high-risk populations. " 08/01/1996 - "Ondansetron, a selective serotonergic (5-HT3) antagonist, is effective in reducing postoperative vomiting in several high-risk populations. "
2.	Dexamethasone (Maxidex)FDA LinkGeneric 02/01/2001 - "Of them, dexamethasone used as a prophylactic drug for PONV provided the best results. " 01/01/2008 - "Dexamethasone has been proven effective in the prophylaxis of late PONV. " 01/01/2014 - "Dexamethasone 8-10mg had a significantly greater effect for reducing the incidence of PONV than dexamethasone 1.25-5mg. " 08/01/2007 - "A single dose of dexamethasone significantly decreased the incidence of postoperative vomiting in early and late recovery phase and shortened the time to first oral intake and the duration of IV therapy." 03/01/2001 - "Dexamethasone significantly decreased the incidence of postoperative vomiting during the first 24 h, shortened the time to the first oral intake and the duration of IV hydration, and improved the quality of oral intake and the satisfaction scores of the patients."
3.	Droperidol FDA LinkGeneric 09/01/1999 - "Treatment with droperidol was more effective when the baseline risk for PONV was higher than 25% for early PONV and 35% for late PONV. " 01/01/2012 - "Low-dose droperidol (10 µg/kgBW) was found to be effective as rescue medication in pediatric patients experiencing PONV despite various prophylactic antiemetic regimens. " 09/01/2005 - "All treatment groups, except droperidol during the postoperative 3-24 h, were effective for prevention of postoperative nausea and vomiting during the postoperative 0-24 h." 09/01/2001 - "The continuous epidural administration of droperidol is effective in prevention of postoperative nausea and vomiting and the effect lasts during its infusion with no side effects." 09/01/2000 - "Droperidol was effective for this purpose with incidence of PONV of 25% (P < 0.05). "
4.	Granisetron (Kytril)FDA LinkGeneric 02/01/1998 - "Granisetron is highly effective for reducing the incidence of PONV in female patients undergoing breast surgery. " 07/01/1998 - "This study was designed to evaluate the efficacy of granisetron administered orally for preventing PONV in female patients undergoing major gynaecological surgery. " 01/01/2012 - "Efficacy of Generic Granisetron vs Kytril® for PONV in Major Gynecological Operations: A Randomized, Double-blind Clinical Trial." 03/01/2001 - "Preoperative oral granisetron, in doses of more than 2 mg, is effective for the prevention of postoperative nausea and vomiting in women undergoing general anaesthesia for breast surgery." 09/01/1998 - "We conclude that preoperative oral granisetron, in doses more than 40 micrograms kg-1, was effective for the prevention of postoperative vomiting in children."
5.	Metoclopramide (Reglan)FDA LinkGeneric 03/01/2012 - "In conclusion, this review suggests that metoclopramide is effective and safe for IONV and PONV prophylaxis in this patient population. " 11/01/2012 - "A post hoc analysis examining three studies with questioned validity performed by the author Yoshitaka Fujii that would meet criteria for inclusion in the current study did not demonstrate a significant benefit of metoclopramide compared with control on the incidence of 24 h PONV. " 11/01/2012 - "Thirty trials evaluating the effect of 10 mg systemic metoclopramide in 3328 subjects on PONV outcomes were included. " 11/01/2012 - "A wide search was performed to identify randomized clinical trials that evaluated systemic 10 mg metoclopramide as a prophylactic agent to reduce PONV. " 11/01/2012 - "The objective of the current study was to examine the effect of a systemic dose of 10 mg metoclopramide to prevent PONV. "
6.	ramosetron (Nasea)IBA 11/01/2011 - "Compared with placebo, the efficacy of 0.3 mg ramosetron in adults and 6 µg/kg in children were consistently beneficial in preventing PONV overall (RR: 0.4; 95% CI: 03-0.6). " 04/01/2011 - "Prophylactic therapy with ramosetron is effective for preventing PONV in adults and POV in children without clinically serious adverse effects." 09/01/2008 - "Ramosetron is effective for the long-term (up to 48 h) prevention of PONV. " 01/01/2006 - "Ramosetron is effective for the long-term (up to 48 hours) prevention of PONV. " 01/01/2005 - "Ramosetron is effective for the long-term prevention of PONV. "
7.	Propofol (Diprivan)FDA LinkGeneric 06/01/1999 - "Propofol is effective in managing PONV with shorter PACU stay and great degree of patient satisfaction. " 11/01/1996 - "Propofol used only as an induction agent or for induction and at the end of surgery were not as protective against postoperative nausea and vomiting." 06/01/1999 - "This study determines the efficacy of small doses of propofol administered by patient-controlled device for the treatment of PONV. " 08/01/1998 - "Lack of efficacy of propofol in the treatment of early postoperative nausea and vomiting." 07/01/2013 - "The study found that the PONV was significantly reduced in the patient with propofol, no hemodynamic derangements were noted in the postoperative period."
8.	AntiemeticsIBA 05/01/1998 - "The willingness-to-pay technique was used to value the intangible benefits, such as relief from anxiety and discomfort, resulting from a reduction in postoperative emesis in children; anxiety and discomfort are currently excluded from most cost-effectiveness studies of antiemetic agents. " 12/01/2002 - "To effectively prevent and treat PONV, it is important to understand the factors implicated in PONV, the mechanisms of PONV, the pharmacology of the antiemetic agents, and the nonpharmacologic measures that have been shown to be effective. " 02/01/2011 - "Combination antiemetic therapy often is effective for preventing PONV in patients undergoing LC, and combinations of antiemetics targeting different sites of activity may be more effective than monotherapy. " 09/01/2003 - "Prophylaxis with a combination of antiemetic drugs is more effective in prevention of PONV." 10/01/1996 - "Overall incidence of PONV was determined for all groups and the relative efficacy of the three antiemetic agents assessed. "
9.	Serotonin (5 Hydroxytryptamine)IBA 10/01/2002 - "5-HT 3 receptor antagonists are highly effective in prevention and management of PONV. " 01/01/2005 - "Selective serotonin 5-HT(3) receptor antagonists have proven safe and effective for the management of postoperative nausea and vomiting. " 02/01/2012 - "A network meta-analysis on the efficacy of serotonin type 3 receptor antagonists used in adults during the first 24 hours for postoperative nausea and vomiting prophylaxis." 12/01/2006 - "The use of selective 5-hydroxytryptamine type 3 receptor antagonists has improved the management of postoperative nausea and vomiting, but has not completely eliminated it. " 12/01/2006 - "Pharmacology, pharmacogenetics, and clinical efficacy of 5-hydroxytryptamine type 3 receptor antagonists for postoperative nausea and vomiting."
10.	dolasetron mesylate (dolasetron)FDA Link 09/01/1997 - "Dolasetron is effective for treating PONV and has an adverse event profile similar to that of placebo. " 02/01/2003 - "This prospective, randomized, double-blind study was performed to evaluate the efficacy of prophylaxis with dolasetron in reducing the frequency of postoperative nausea and duration of discharge time. " 12/01/2002 - "The results of our study suggest that dolasetron was more effective than MCP and placebo in preventing PONV. " 02/01/2000 - "Pooled analysis of three large clinical trials to determine the optimal dose of dolasetron mesylate needed to prevent postoperative nausea and vomiting. " 01/01/2000 - "The Dolasetron PONV Prevention Study Group."

Therapies and Procedures

1.	Laparoscopic Cholecystectomy 03/01/2009 - "Numerous studies have shown that TIVA is followed by a significant reduction in the incidence of PONV in day-case surgery, including laparoscopic cholecystectomy, where the incidence of PONV can reach 70% according to some studies. " 01/01/2005 - "Combination antiemetic therapy is often effective for the prevention of PONV following laparoscopic cholecystectomy. " 03/01/2007 - "This randomized double-blind study was undertaken to evaluate the efficacy of ondasetron and dexamathesone in reducing the incidence of postoperative nausea and vomiting after laparoscopic cholecystectomy. " 01/01/2014 - "In this study, our aim was to determine the effects of preoperative intravenous hydration on postoperative nausea and vomiting in high Apfel scored patients undergoing laparoscopic cholecystectomy surgery. " 08/01/2002 - "This study has shown that perioperative gastric emptying is not a predictor of early postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy."
2.	Anesthesia 11/01/2012 - "Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. " 10/01/2008 - "The presence of heterogeneity and inconsistent results among the included trials prevents any definitive conclusions on the efficacy of P6 stimulation in reducing IONV and PONV associated with cesarean delivery performed under neuraxial anesthesia." 02/01/2013 - "The second purpose of this study was to collect information on PONV risk factors, independently, in the categories of patient-related, anesthesia-related, and surgery-related factors. " 01/01/2011 - "There was no statistically significant difference between the study groups with respect to the number of children with postoperative vomiting during all time periods after anesthesia. " 01/01/2006 - "The goal of this study was to assess the responses to a written survey to address the following questions: 1) If no prophylaxis is administered to an ambulatory patient, what agent do anesthesiologists use for treatment of PONV in the ambulatory Post-Anesthesia Care Unit (PACU)?; 2) Do anesthesiologists use non-pharmacologic interventions for PONV treatment?; and 3) If a PONV prophylaxis agent is administered during the anesthetic, do anesthesiologists choose an antiemetic in a different class for treatment? "
3.	General Anesthesia 09/01/2015 - "In conclusion, we think that a sub-Tenon's block, combined with general anesthesia, is not effective and reliable in decreasing oculocardiac reflex and postoperative nausea and vomiting. " 09/01/2015 - "In conclusion, we think that a sub-Tenon's block, combined with general anesthesia, is not effective and reliable in decreasing oculocardiac reflex and postoperative nausea and vomiting. " 02/01/2015 - "Three hundred and eighty-four patients who had at least one risk factors of PONV and underwent surgery under general anesthesia were screened. " 01/01/2015 - "Postoperative nausea and vomiting was more frequent among patients recovering in general anesthesia group. " 01/01/2015 - "Postoperative nausea and vomiting is a common side effect of general anesthesia. "
4.	Tonsillectomy 01/01/2005 - "A three-year observational study of patients undergoing tonsillectomy at the University Hospital of the West Indies was conducted to determine the incidence of postoperative vomiting. " 10/01/2015 - "Specific FAAH polymorphisms are associated with refractory PONV, opioid-related RD, and prolonged PACU stay due to opioid adverse effects in white children undergoing tonsillectomy." 10/01/2015 - "Five specific FAAH single nucleotide polymorphisms (SNPs) had significant associations with more than twofold increased risk for refractory PONV (adjusted P<0.0018), and nominal associations (P<0.05) with RD and prolonged PACU stay in white children undergoing tonsillectomy. " 04/01/2013 - "Postoperative vomiting (POV) is one of the most frequent complications of tonsillectomy in children. " 09/01/2008 - "Postoperative vomiting (POV) is a common complication after tonsillectomy. "
5.	Thyroidectomy 04/01/2013 - "This study compared the incidence of PONV in the women who underwent open or robot-assisted thyroidectomy. " 12/01/2015 - "PONV is an unsettling problem that commonly occurs in patients after thyroidectomy. " 04/01/2013 - "Robotic thyroidectomy reduces the incidence and severity of PONV compared to open thyroidectomy during a 0-24-h postoperative period." 04/01/2013 - "Comparison of the incidence of postoperative nausea and vomiting between women undergoing open or robot-assisted thyroidectomy." 01/01/2013 - "There is a particularly high incidence of postoperative nausea and vomiting following thyroidectomy. "