What is PONV anesthesia?
The term PONV is typically used to describe nausea and/or vomiting or retching in the post-anesthesia care unit (PACU) or in the immediate 24 postoperative hours. Postdischarge nausea and vomiting (PDNV) refers to symptoms that occur after discharge for outpatient procedures.
What is PONV risk?
PONV was defined as nausea or vomiting within 24 h of surgery. Risk scores to estimate the probability of PONV were obtained by fitting logistic regression models. Simplified risk scores were constructed based on the number of risk factors that were found significant in the logistic regression analyses.
Why does PONV happen?
Risk factors PONV results from patient, surgical, and anesthetic factors. Surgical factors that confer increased risk for PONV include procedures of increased length and gynecological, abdominal, laparoscopic and ENT procedures, and strabismus procedures in children.
What is a PONV score?
What is the strongest antiemetic?
Triple therapy comprising palonosetron, aprepitant and dexamethasone seems to be the strongest antiemetic treatment.
Does propofol cause PONV?
It has been shown that propofol for anaesthesia is associated with less PONV than volatile agents, but that it reduced only early PONV.
How common is PONV?
PONV is one of the most common causes of patient dissatisfaction after anaesthesia, with reported incidences of 30% in all post-surgical patients and up to 80% in high-risk patients.
Who is most at risk for PONV?
Female gender is the strongest patient specific predictor of PONV, followed by history of PONV or motion sickness, non-smoking status, and younger age. Anesthesia related factors include the use of volatile anesthetics, duration of anesthesia, perioperative opioid use, and use of nitrous oxide.
How to perform a spinal anesthesia?
Now the anesthetist will feel the back firmly, to exactly locate the space where to inject the spinal anesthesia. The anesthesia injected will numb the skin first and then the fine spinal needle is inserted. During this moment, the patient needs to stay still.
What causes postoperative nausea and vomiting (PONV) after spinal anesthesia?
Spinal anesthesia itself may cause IONV or postoperative nausea and vomiting (PONV) via a variety of mechanisms, including hypotension, intrathecal additives, inadequate nerve block, or high nerve block.
Can spinal anesthesia cause peripheral nerve damage?
Peripheral Nerve Injury Spinal anesthesia may indirectly result in peripheral nerve injury. The sensory nerve block induced by spinal anesthesia temporarily abolishes normal protective reflexes. Therefore, care must be taken with appropriate positioning, avoidance of tight plaster casts, and observation of distal circulation.
When is the prone position used for spinal anesthesia?
The prone position is utilized for spinal anesthesia if the patient needs to be in this position for the surgery, such as for rectal, perineal, or lumbar procedures.