Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Dec 2006
ReviewEvidence-based interventions for post discharge nausea and vomiting: a review of the literature.
Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) continue to be a problem for one third of all patients who require surgery and anesthesia. Very few studies have been reported that specifically target PDNV in the outpatient surgery population for interventions after discharge home. Twenty studies were identified that specifically addressed the effect of an intervention for the purpose of preventing PDNV or rescuing the patient who develops PDNV. This article presents an integrative review of the research literature to determine the best evidence for prevention of PDNV in adults or for the rescue of patients who suffer from PDNV.
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J. Perianesth. Nurs. · Dec 2006
ReviewTherapeutic modalities for the prophylactic management of postoperative nausea and vomiting.
The occurrence of postoperative nausea and vomiting (PONV) remains one of the most common complications after general anesthesia. The causes of PONV are multimodal, involving several physiologic pathways that stimulate the vomiting center, including the chemoreceptor trigger zone, the gastrointestinal tract, the vestibular system, the cerebral cortex, and the midbrain. ⋯ The addition of therapeutic modalities to the arsenal of prophylactic management techniques may decrease patient incidence of PONV by directing treatment to various pathways that stimulate the vomiting center. The purpose of this article is to review briefly the literature and discuss three therapeutic modalities for preventing PONV: perioperative oxygen administration, perioperative intravenous fluid administration, and differing fasting protocols.
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J. Perianesth. Nurs. · Dec 2006
ReviewIdentification of risk factors for postoperative nausea and vomiting in the perianesthesia adult patient.
Postoperative nausea and vomiting (PONV) is a common and potentially debilitating complication of surgery. The preoperative assessment of PONV using established risk assessment tools enables the identification of patients at risk and potentially decreases the incidence of PONV in adult surgical patients. The identification of risk factors associated with PONV and the factors that are independent predictors of PONV preoperatively can facilitate the effective prophylactic treatment and management of PONV in adult surgical patients.
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J. Perianesth. Nurs. · Dec 2006
ReviewPharmacological prophylaxis and management of adult postoperative/postdischarge nausea and vomiting.
Postoperative nausea and vomiting (PONV) is a relatively common complication that can adversely affect the quality of a patient's postoperative recovery. Factors to consider when determining a patient's risk for developing PONV include female gender, history of PONV, history of motion sickness, nonsmoking status, postoperative use of opioids, use of inhaled anesthetic agents, and use of nitrous oxide. Receptors that, when activated, can cause PONV include dopamine type-2, serotonin type-3, histamine type-1, muscarinic cholinergic type-1, and neurokinin type-1. ⋯ In addition, the patient's risk could be reduced by considering the use of regional anesthesia, maintaining general anesthesia with propofol rather than with inhaled anesthetic agents, ensuring good intravenous hydration, and providing effective pain management using a multimodal approach (eg, minimizing the use of opioids). If PONV does occur in the immediate postoperative period, it is best treated with an antiemetic agent from a different pharmacologic class than the agent that was administered for prophylaxis. Once a patient is discharged, alternative formulations of antiemetics such as ondansetron oral or dissolving tablets or promethazine tablets or suppositories can be used.
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J. Perianesth. Nurs. · Dec 2006
ReviewPrevention and management of postoperative nausea and vomiting: a look at complementary techniques.
Complementary modalities, used alone or in combination with pharmacologic therapies, play an important role in the prevention and management of postoperative nausea and vomiting (PONV) and post discharge nausea and vomiting (PDNV). This article will review the evidence for the effective use of complementary modalities: acupuncture and related techniques, aromatherapy, and music therapy that may be integrated in the perianesthesia nurse's plan of care to prevent or manage PONV.