Akademik Veri Yönetim Sistemi
Anestezi Dergisi, cilt.15, sa.4, ss.203-213, 2007 (Scopus)
Worldwide annually, approximately 80-100 million operations are performed under general anesthesia. For various reasons, postoperative nausea and vomiting (PONV) are recorded in 20-30% of the procedures during the first 24 hours. This population includes both the patients without any risk factors and the patients with important risk factors that can be determined before the procedure. Nausea and vomiting are considered as an important symptom because they decrease the quality of life even more than postoperative pain and cause anxiety. Furthermore, they can cause complications such as dehydration, electrolite imbalance, aspiration, pneumonia; separation of the incision scar, haemorrhage which may lead to medical therapy or secondary surgery procedures. Such complications result in loss of time, money and manpower Recently prolonged post-operative hospital stays, complications and unplanned admissions illustrate the importance of the prevention, management and therapy of nausea and vomiting. The primary therapy for PONV is antimuscarinics, antihistaminics, dopamin D2 receptor antagonists and serotonin antagonists. Serotonin antagonists are effective, safe and have fewer side effects and therefore are preferred for nausea related to surgery, chemotherapy or radiotherapy. Antimuscarinics have anticolinergic, antihistaminics have sedation and dopamin antagonists have extrapyramidal side effects. Alternative methods like corticosteroids, sedatives, anxiolytics, substance-P antagonists and acupressure can be combined with the therapy for patient relief. Medications that affect different receptors and combination therapies are recommended for patients with risk factors. Despite all these therapeutic choices, cost benefit is an important predictor in planning the therapy.