Prevención y tratamiento de náuseas y vómitos postoperatorios / Prevention and treatment of postoperative nausea and vomiting

Las náuseas y vómitos postoperatorios son complicaciones habituales de la anestesia y la cirugía en la práctica diaria, por lo que todo cirujano debe ser capaz de reconocerlas y enfrentarlas como tal. Sin embargo, la prevención y manejo de éstos no siempre es el adecuado, lo cual repercute en el confort de los pacientes. Descartando que esta complicación sea secundaria a la intervención quirúrgica, es necesario tener conocimiento respecto al arsenal farmacológico disponible en nuestro medio que nos permita un postoperatorio mejor tolerado. El objetivo de este trabajo es dar a conocer la evidencia actual respecto al óptimo manejo de estas complicaciones.

The postoperative nausea and vomiting are common complications of anesthesia and surgery in daily practice, so that every surgeon should be proficient to recognize and treat them as such. However, their prevention and management is not always adequate, which affects the comfort of patients. Discarding this complication secondary to surgical intervention, is necessary to have knowledge about the pharmacological arsenal available in our environment that allows us a better tolerated postoperatively. The aim of this paper is to present the current evidence regarding the optimal management of these complications.

Postoperative nausea and vomiting. a review

Post operative nausea and vomiting [PONV] remains an unpleasant and persistent problem for patients undergoing surgery. In fact PONV are among the most important factors contributing to delay in discharge of patients and an increase in unanticipated admissions after ambulatory surgery. Anesthesia providers are most often blamed for PONV, sometimes rightfully so, many times wrongly so. PONV is a multifactorial issue involving many physiological and biological mechanisms. As the trend towards ambulatory surgery increases, PONV continues to pose serious challenges for anesthesia providers because the potential cost savings of performing surgeries on an ambulatory basis may be negated by unanticipated hospital admission. Although PONV may be unavoidable in some patients for reasons we do not fully understand, there are risk factors that can be identified. As anesthesiologists it is essential for us to understand the mechanisms involved in nausea and vomiting and the available perioperative treatment options. We must do whatever we can to prevent and treat PONV and improve patient outcome for both medical and economic reasons