Postoperative nausea and vomiting: Literature review
DOI:
https://doi.org/10.33448/rsd-v13i6.46142Keywords:
Postoperative Nausea and Vomiting; Anesthesiology; Anesthesia recovery period.Abstract
The term postoperative nausea and vomiting (PONV) is commonly used to describe nausea and/or vomiting in the post-anesthesia recovery room (PACU) or within the immediate 24-hour postoperative period. It is characterized as a multifactorial adverse response to anesthesia and surgical operation that is feared by patients, usually classified as worse than postoperative pain. This study aimed to provide the most up-to-date information regarding the pathophysiology, risk factors, prophylaxis, and treatment of PONV, based on scientific evidence and the latest guidelines. The presented research refers to a narrative review of the literature. Searches were conducted in journals indexed in the PubMed, LILACS, and SciELO databases. Additionally, a search was made in books of significant importance in the field of Anesthesiology. Although not yet fully elucidated, some pathophysiological pathways of PONV are already well described. Regarding risk factors, the literature establishes some factors such as female sex, non-smoker status, history of PONV, and opioid use in surgery, in addition to other factors that are discussed. Prophylaxis and treatment are based on the guideline released in 2020 by Gan and colleagues. PONV carries a negative impact on patient well-being. Thus, PONV constitutes a complication with high impact and prevalence, despite advances in science regarding the topic. It is the physician's role to be aware of the risks in order to avoid such complication.
References
Apfel, C. C., Heidrich, F. M., Jukar-Rao, S., Jalota, L., Hornuss, C., Whelan, R. P., Zhang, K., & Cakmakkaya, O. S. (2012). Evidence-based analysis of risk factors for postoperative nausea and vomiting. British journal of anaesthesia, 109(5), 742–753. https://doi.org/10.1093/bja/aes276
Cangiani, L. M., Carmona, M. J. C., Ferez D., Bastos, C. O., Duarte, L. T. D., Cangiani, L. H., Falcão, L. F. R., Tardelli, M. A., & Rodrigues, R. C. (2021). Tratado de Anestesiologia - SAESP (9ª edição). Editora dos Editores.
Cordeiro, A. M., Oliveira, G. M. D., Rentería, J. M., & Guimarães, C. A. (2007). Revisão sistemática: uma revisão narrativa. Revista do colégio brasileiro de cirurgiões, 34, 428-431.
Eberhart, L. H. J., Geldner, G., Kranke, P., Morin, A. M., Schäuffelen, A., Treiber, H., & Wulf, H. (2004). The development and validation of a risk score to predict the probability of postoperative vomiting in pediatric patients. Anesthesia and analgesia, 99(6), 1630–1637. https://doi.org/10.1213/01.ANE.0000135639.57715.6C
Elvir-Lazo, O. L., White, P. F., Yumul, R., & Cruz Eng, H. (2020). Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review. F1000Research, 9, F1000 Faculty Rev-983. https://doi.org/10.12688/f1000research.21832.1
Feenstra, M. L., Jansen, S., Eshuis, W. J., van Berge Henegouwen, M. I., Hollmann, M. W., & Hermanides, J. (2023). Opioid-free anesthesia: A systematic review and meta-analysis. Journal of clinical anesthesia, 90, 111215. https://doi.org/10.1016/j.jclinane.2023.111215
Feinleib, J., Lori, H. K., &nAmmar Y. (2024). https://www.uptodate.com/contents/postoperative-nausea-and-vomiting?search=ponv&source=search_result&selectedTitle=1%7E150&usage_type=default&displayrank=1. Acesso em 15 de abril de 2024.
Gan, T. J., Belani, K. G., Bergese, S., Chung, F., Diemunsch, P., Habib, A. S., Jin, Z., Kovac, A. L., Meyer, T. A., Urman, R. D., Apfel, C. C., Ayad, S., Beagley, L., Candiotti, K., Englesakis, M., Hedrick, T. L., Kranke, P., Lee, S., Lipman, D., Minkowitz, H. S., … Philip, B. K. (2020). Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesthesia and analgesia, 131(2), 411–448. https://doi.org/10.1213/ANE.0000000000004833
Gress, K., Urits, I., Viswanath, O., & Urman, R. D. (2020). Clinical and economic burden of postoperative nausea and vomiting: Analysis of existing cost data. Best practice & research. Clinical anaesthesiology, 34(4), 681–686. https://doi.org/10.1016/j.bpa.2020.07.003
Gropper, M. A., Cohen, N. H., Eriksson, L. I., Fleisher, L. A., Leslie, K., & Wiener-Kronish, J. P. (2019). Miller’s Anesthesia (9ª ed.). Elsevier.
Guimarães, G. M. N., Silva, H. B. G. D., & Ashmawi, H. A. (2020). Fatores de risco para náusea e vômitos após cesariana: estudo prognóstico prospectivo [Risk factors for post-caesarean nausea and vomiting: a prospective prognostic study]. Brazilian journal of anesthesiology (Elsevier), 70(5), 457–463. https://doi.org/10.1016/j.bjan.2020.08.003
Horn, C. C., Wallisch, W. J., Homanics, G. E., & Williams, J. P. (2014). Pathophysiological and neurochemical mechanisms of postoperative nausea and vomiting. European journal of pharmacology, 722, 55–66. https://doi.org/10.1016/j.ejphar.2013.10.037
Huh H. (2023). Postoperative nausea and vomiting in spinal anesthesia. Korean journal of anesthesiology, 76(2), 87–88. https://doi.org/10.4097/kja.23157
Jin, Z., Gan, T. J., & Bergese, S. D. (2020). Prevention and Treatment of Postoperative Nausea and Vomiting (PONV): A Review of Current Recommendations and Emerging Therapies. Therapeutics and clinical risk management, 16, 1305–1317. https://doi.org/10.2147/TCRM.S256234
Liu, Y., Chen, X., Wang, X., Zhong, H., He, H., Liu, Y., Liao, Y.,Pan, Z., Hu, W., Liu, W., & Zheng, F. (2023). The efficacy of aprepitant for the prevention of postoperative nausea and vomiting: A meta-analysis. Medicine, 102(29), e34385. https://doi.org/10.1097/MD.0000000000034385
Morrison, C., & Wilmshurst, S. (2019). Vômitos pós-operatórios em crianças. Educação BJA,19(10), 329–333. https://doi.org/10.1016/j.bjae.2019.05.006
Rother, E. T. (2007). Revisão sistemática X revisão narrativa. Acta Paulista De Enfermagem, 20(2), v–vi. https://doi.org/10.1590/S0103-21002007000200001
Schmidt, A. P. (2020). Prevention of postoperative nausea and vomiting: new insights for patient care. Revista Brasileira De Anestesiologia, 70(5), 452–454. https://doi.org/10.1016/j.bjane.2020.09.004
Sizemore, D. C., Singh, A., Dua, A., Singh, K., & Grose, B. W. (2022). Postoperative Nausea. In StatPearls. StatPearls Publishing.
Stoops, S., & Kovac, A. (2020). New insights into the pathophysiology and risk factors for PONV. Best practice & research. Clinical anaesthesiology, 34(4), 667–679. https://doi.org/10.1016/j.bpa.2020.06.001
Urits, I., Orhurhu, V., Jones, M. R., Adamian, L., Borchart, M., Galasso, A., & Viswanath, O. (2020). Postoperative Nausea and Vomiting in Paediatric Anaesthesia. Turkish journal of anaesthesiology and reanimation, 48(2), 88–95. https://doi.org/10.5152/TJAR.2019.67503
Veiga-Gil, L., Pueyo, J., & López-Olaondo, L. (2017). Postoperative nausea and vomiting: physiopathology, risk factors, prophylaxis and treatment. Náuseas y vómitos postoperatorios: fisiopatología, factores de riesgo, profilaxis y tratamiento. Revista espanola de anestesiologia y reanimacion, 64(4), 223–232. https://doi.org/10.1016/j.redar.2016.10.001
Weibel, S., Schaefer, M. S., Raj, D., Rücker, G., Pace, N. L., Schlesinger, T., Meybohm, P., Kienbaum, P., Eberhart, L. H. J., & Kranke, P. (2021). Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: an abridged Cochrane network meta-analysis. Anaesthesia, 76(7), 962–973. https://doi.org/10.1111/anae.15295,
Zhou, C. M., Wang, Y., Xue, Q., Yang, J. J., & Zhu, Y. (2023). Predicting early postoperative PONV using multiple machine-learning- and deep-learning-algorithms. BMC medical research methodology, 23(1), 133. https://doi.org/10.1186/s12874-023-01955-z
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Copyright (c) 2024 Márcio Duarte Carvalho Alves; Marcos Cauã Sena de Andrade; Leandro Mota Coutinho Inácio de Souza; Vítor Andrade de Oliveira; Fernando Sobral Felizola Freire; Rodrigo Medeiros Resende; Antônio Gabriel Santos
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