Postoperative Nausea and Vomiting in Pediatric Anesthesia [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-67503

Postoperative Nausea and Vomiting in Pediatric Anesthesia

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
2Creighton University School of Medicine Phoenix Regional Campus, Phoenix, AZ
3Georgetown University School of Medicine, Washington, DC
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

Background: Postoperative nausea and vomiting (PONV) is a common complication in pediatric anesthesia that is a source of significant morbidity. Various independent risk factors have been implicated in the development of pediatric PONV and include higher pain scores postoperatively, the use of opioids for pain management, and the use of volatile anesthetics for maintenance of anesthesia.
Methods: This review of current literature regarding the prevention and treatment of pediatric PONV is based on a search of PubMed to identify published clinical trials, systematic reviews, and meta-analyses.
Results: While the occurrence of PONV in many cases is difficult to entirely avoid, risk can be mitigated by the use of multimodal nonopioid analgesic regimens, total intravenous in favor of volatile anesthetic, and appropriate prophylactic pharmacotherapy. Frequently administered drug classes for the prevention of PONV include corticosteroids, 5HT3 antagonists, and anticholinergics. The clinical use of findings in literature may help improve the occurrence of PONV in children.
Conclusion: In this review we provide an update on risk factors contributing the occurrence of PONV in children, outline current opinion on pharmacotherapy that commonly used for management, and provide an overview of guidelines that are used to help guide prophylaxis and treatment of pediatric PONV.

Keywords: Postoperative nausea and vomiting (PONV), anesthesia, risk factors, guidelines for prophylaxis and treatment




Corresponding Author: Ivan Urits, United States


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