Featured Research

from universities, journals, and other organizations

New Guidelines For Postoperative Nausea And Vomiting

Date:
October 17, 2006
Source:
Duke University Medical Center
Summary:
After five years of reviewing the latest research findings, a panel of experts led by a Duke University Medical Center anesthesiologist has developed new guidelines to help physicians reduce the occurrence of nausea and vomiting in patients after surgery.

After five years of reviewing the latest research findings, a panel of experts led by a Duke University Medical Center anesthesiologist has developed new guidelines to help physicians reduce the occurrence of nausea and vomiting in patients after surgery.

Related Articles


Despite decades of advances in surgical techniques and improved anesthetic agents, one out of three patients still experiences postoperative nausea and vomiting, said Duke anesthesiologist Tong J. Gan, M.D., leader of the panel that developed the guidelines. Such conditions not only can lead to patient dissatisfaction, but also can lengthen hospital stays and prolong recovery, he said.

Gan presented the new guidelines, one set for adults and one for children, on Monday, Oct. 16, at the annual scientific meeting of the American Society of Anesthesiologists, in Chicago. The panel, which included anesthesiologists, surgeons, pharmacists, nurse anesthetists and biostatisticians, was commissioned and supported by the Society of Ambulatory Anesthesia.

The guidelines incorporate the use of new drugs, known as antiemetics, which patients receive prior to surgery to prevent nausea and vomiting. The researchers also found that combining different classes of antiemetics added to their effectiveness.

The guidelines also provide new information that should help physicians identify which patients are at the greatest risk for nausea and vomiting and therefore should receive antiemetics prior to surgery.

"The results of more than 250 trials of antiemetics have been published since the last guidelines were developed five years ago," Gan said. "The new guidelines incorporate much of this new information and provide physicians with up-to-date strategies for preventing and treating postoperative nausea and vomiting."

Children are twice as likely as adults to develop postoperative nausea and vomiting, Gan said, and the panel developed a simple four-point scoring system for identifying those children at highest risk. The four factors are: when a surgical procedure lasts more than 30 minutes; when children are three years of age or older; when there is a family history of postoperative nausea and vomiting; and when the surgery is to correct strabismus, or crossed eyes.

"If one of these risk factors is present, then there is a 10 percent chance of postoperative nausea and vomiting," Gan said. "Each additional factor adds another 20 percent chance, meaning that a child with all four would be at a 70 percent risk. Since the previous guidelines were developed, there have been a number of effective antiemetics approved for use in children, and we would recommend that children identified as being at high risk should be given a combination of these drugs."

For adults, the factors that elevate risk include being female, being a nonsmoker and having a family history of motion sickness or postoperative nausea and vomiting. Also, long surgeries, or those that use nitrous oxide as an agent of general anesthesia, increase risk, Gan said, as does the use of opioids to control pain after surgery.

The panel concluded that being obese does not increase a patient's chances of suffering from nausea and vomiting, as was previously thought, Gan said. Additionally, giving patients 100 percent oxygen during surgery -- a common preventive strategy -- does not appear to be effective in controlling nausea and vomiting.

The research team also looked at nontraditional preventive methods.

"We have seen more support among the medical community for the use of acupuncture before and during surgery to control postoperative nausea and vomiting," said Gan, who recently conducted a study which found that the ancient Chinese practice is effective for managing the disorder in women undergoing major breast surgery. [link] "However, we also found that hypnosis before surgery was not effective as a preventive measure."

According to Gan, postoperative nausea and vomiting does not receive enough attention from the medical community.

"There are more than 35 million surgical procedures performed each year in the United States, so this is an extremely important health care issue," Gan said. "It is also an issue that most physicians do not take seriously enough; they see it as a short-term nuisance that will soon pass. However, studies have shown that nausea and vomiting after surgery is the major factor influencing whether or not patients are satisfied with their surgery."

The issue is also important for patients who go home in the afternoon after having surgery in the morning.

"More than 70 percent of all surgeries in the United States are performed as day cases, and the persistence of nausea and vomiting symptoms beyond discharge after surgery pose a great challenge to both patients and their physicians," Gan said. "So it is important to consider postoperative nausea and vomiting before surgery and have an effective strategy to manage it."


Story Source:

The above story is based on materials provided by Duke University Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

Duke University Medical Center. "New Guidelines For Postoperative Nausea And Vomiting." ScienceDaily. ScienceDaily, 17 October 2006. <www.sciencedaily.com/releases/2006/10/061016150744.htm>.
Duke University Medical Center. (2006, October 17). New Guidelines For Postoperative Nausea And Vomiting. ScienceDaily. Retrieved November 24, 2014 from www.sciencedaily.com/releases/2006/10/061016150744.htm
Duke University Medical Center. "New Guidelines For Postoperative Nausea And Vomiting." ScienceDaily. www.sciencedaily.com/releases/2006/10/061016150744.htm (accessed November 24, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, November 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Are Female Bosses More Likely To Be Depressed?

Are Female Bosses More Likely To Be Depressed?

Newsy (Nov. 24, 2014) A new study links greater authority with increased depressive symptoms among women in the workplace. Video provided by Newsy
Powered by NewsLook.com
Winter Can Cause Depression — Here's How To Combat It

Winter Can Cause Depression — Here's How To Combat It

Newsy (Nov. 23, 2014) Millions of American suffer from seasonal depression every year. It can lead to adverse health effects, but there are ways to ease symptoms. Video provided by Newsy
Powered by NewsLook.com
Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

AFP (Nov. 23, 2014) The arable district of Kenema in Sierra Leone -- at the centre of the Ebola outbreak in May -- has been under quarantine for three months as the cocoa harvest comes in. Duration: 01:32 Video provided by AFP
Powered by NewsLook.com
Don't Fall For Flu Shot Myths

Don't Fall For Flu Shot Myths

Newsy (Nov. 23, 2014) Misconceptions abound when it comes to your annual flu shot. Medical experts say most people older than 6 months should get the shot. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins