Despite the advent of new technology and pharmacological agents, postoperat
ive nausea and vomiting (PONV) continues to have an incidence of 20-30% tod
ay. Development of PONV can lead to serious complications such as aspiratio
n, dehydration, electrolyte disturbances and disruption of the surgical sit
e. PONV leads to increased cost of treatment, and may be associated with in
creased anxiety, dissatisfaction with the surgical experience and anticipat
ory nausea in the future. The mechanisms of PONV are examined with associat
ed risk factors. A review of the literature of PONV management is included
covering pharmacological, dietary and behavioural interventions; culminatin
g in the development of assessment and management guidelines and identifica
tion of areas far further study.