Postoperative nausea and vomiting – a narrative review of pathophysiology, pharmacotherapy and clinical management strategies

Abstract

Introduction: Postoperative nausea and vomiting (PONV) are common complications concerning patients undergoing general anesthesia. Intensive research was performed during the last two decades in order to develop therapeutic and prophylactic strategies to prevent this complication.

Areas covered: This article reviews the pathophysiology as well as pharmacological aspects of PONV prophylaxis and treatment. Relevant strategic aspects for pharmacological prophylaxis of PONV are discussed and clinical standard operating procedures are presented.

Expert opinion: The expert opinion focuses on poor implementation of actual PONV guidelines and future considerations.

Keywords:

• anesthesia
• antiemetics
• postoperative complications
• postoperative nausea and vomiting

Acknowledgment

The authors thank Gertrude Duncan, MD for her linguistic improvements of the manuscript.

Declaration of interest

P Kranke was a member of the consensus panel of the international guideline on the management of PONV. P Kranke and L Eberhart have been primary investigator of various clinical studies on the prevention and treatment of PONV, including Phase II and III trials of Acacia Pharma Ldt., UK, GlaxoSmithKline, US, and FreseniusKabi, Germany. He has received lecture fees from FreseniusKabi Germany and Merck. L Eberhart has received lecture fees and compensations for clinical advisory boards from Baxter, FreseniusKabi, Grünenthal, Prostrakan, Sintetica, and TEVA-ratiopharm. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes

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