Prophylaxis and Treatment of Postoperative Nausea and Vomiting

摘要

Postoperative nausea and vomiting (PONV) continues to present a vexing challenge to anesthesia providers. Since being termed "our big little problem" in 1991 by Kapur, it has been one of the most extensively studied topics in anesthesia literature. Indeed, during the period from 1993 to 2003, Medline lists 799 articles published in the English language on PONV. Yet the question of who should receive prophylaxis versus treatment remains controversial. When Kapur called our attention to this problem, the question was, What can we do about this problem? The answer to that question is now known. Scuderi et al has shown that we can provide an anesthetic to high-risk patients that is nearly 100% effective in preventing PONV. The question we now must answer is, Who should receive the additional resources that must be expended to prevent PONV? And how much should be expended to that end?