• Obesity surgery · Aug 2020

    Review

    Antiemetic Prophylaxis and Anesthetic Approaches to Reduce Postoperative Nausea and Vomiting in Bariatric Surgery Patients: a Systematic Review.

    • Zaina Naeem, Ingrid L Chen, Aurora D Pryor, Salvatore Docimo, Tong J Gan, and Konstantinos Spaniolas.
    • Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, 11794-8191, USA.
    • Obes Surg. 2020 Aug 1; 30 (8): 3188-3200.

    AbstractWhile guidelines exist for the management of postoperative nausea and vomiting (PONV) in the general surgical setting, there are no established guidelines for the prevention or treatment of PONV in bariatric patients, in whom PONV contributes significantly to perioperative morbidity and hospital resource utilization. This systematic review found that the multimodal pharmacological approach to PONV prevention recommended in current guidelines for high-risk surgical patients is appropriate for the bariatric subset. This includes multi-agent antiemetic prophylaxis with dexamethasone and one or more agents from other classes, and opioid-free total intravenous anesthesia, though the advantages of the latter need further evaluation. There remains a need for a standardized validated instrument to assess PONV in the bariatric setting.

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