Postoperative Nausea and Vomiting in Paediatric Anaesthesia [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-67503 | DOI: 10.5152/TJAR.2019.67503  

Postoperative Nausea and Vomiting in Paediatric Anaesthesia

Ivan Urits1, Vwaire Orhurhu1, Mark R. Jones1, Leena Adamian2, Matthew Borchart2, Annemarie Galasso3, Omar Viswanath4
1Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA
2Creighton University School of Medicine - Phoenix Regional Campus, Phoenix, AZ, USA
3Georgetown University School of Medicine, Washington, DC, USA
4Valley Anesthesiology and Pain Consultants, Phoenix, AZ; University of Arizona College of Medicine Phoenix, Department of Anesthesiology, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, USA

Postoperative nausea and vomiting (PONV) is a common complication in paediatric anaesthesia and is a source of significant morbidity. Various independent risk factors have been implicated in the development of paediatric PONV, including higher pain scores postoperatively, the use of opioids for pain management and the use of volatile anaesthetics for the maintenance of anaesthesia. This review of the current literature regarding the prevention and treatment of paediatric PONV is based on a search of the PubMed database, which identified published clinical trials, systematic reviews and meta-analyses. While the occurrence of PONV in many cases is difficult to avoid entirely, the risk can be mitigated by the use of multimodal nonopioid analgesic regimens, total intravenous drugs in favour of volatile anaesthetics and an appropriate regimen of prophylactic pharmacotherapy. Frequently administered drug classes for the prevention of PONV include corticosteroids, 5HT3 antagonists and anticholinergics. The clinical use of the findings in the literature may help to reduce the occurrence of PONV in children. In this review, we provide comprehensive and updated information on the risk factors contributing the occurrence of PONV in children, outline the current opinion on the drugs that are commonly used for management and provide an overview of the guidelines that are used to help establish the prophylaxis and treatment of paediatric PONV.

Keywords: Anaesthesia, guidelines for prophylaxis and treatment, postoperative nausea and vomiting, risk factors

Corresponding Author: Ivan Urits, United States

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