Annals of palliative medicine
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Postoperative nausea and vomiting (PONV) remains a significant clinical issue that can detract from patients' quality of life in hospital/treatment facility, as well as in the days immediately postdischarge. In addition, PONV may increase perioperative costs, increase perioperative morbidity, increase postanesthesia care unit stay, prolong hospital stays, length of stay/delay discharge, delay the time that the patient can go back to work, and lead to readmissions. Despite the existence of multiple tools to stratify patients according to their risk of developing PONV and multiple PONV treatment guidelines, clinicians do not appear to systematically address the treatment and/or prophylaxis of PONV in a uniform fashion with both pharmacologic and nonpharmacologic strategies in attempts to minimize PONV occurrences.
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There are multiple potential states and/or symptoms that may occur in the palliative care population including: pain, nausea/vomiting, fatigue, anorexia, dyspnea, hiccups, cough, constipation, abdominal cramps/bloating, diarrhea, pruritis, depression/anxiety, dysphagia and sleep disturbances. Some of this may be the direct result of medications or drug-drug interactions from agents prescribed to treat the medical conditions that the patient has. Medication-related nausea and vomiting (MRNV) is a significant problem in palliative medicine that is reasonably common likely due to the multiple medications that these patients are often taking.