POSTOPERATIVE NAUSEA AND VOMITING - DO THEY MATTER

Post-operative nausea and vomiting (PONV) has been described as the 'b ig little problem'. With the marked improvement in anaesthetic-related mortality and life-threatening morbidity, attention has increasingly focused on the control of post-operative pain and emetic symptoms. Whi le much effort has been rightly centred on attempts to reduce post-ope rative pain, not enough attention has been given to the management of PONV. Yet many patients consider this complication to be as debilitati ng as the pain associated with the surgical procedure. With the advent of newer drugs such as the anti-serotonin agents (e.g. ondansetron an d granisetron), propofol and eltanolone, parenteral non-steroidal anti -inflammatory agents and rapid, shorter-acting neuromuscular blocking drugs that do not require routine antagonism, the incidence of emesis has been decreased. Abolition of the requirement that patients drink l iquids prior to discharge from the ambulatory care centre has also hel ped to reduce PONV.