Abstract

Postoperative nausea and vomiting (PONV) is a common postoperative issue. Strategies for PONV prevention serve as the basis for risk assessment, Apfel score is used to assess PONV risk in adults and Eberhart’s score is used in children. For PONV reduction, a number of precautions can be taken: modification of anaesthesia technique (local instead of general anesthesia, usage of TIVA instead of volatile anaesthetics), pharmacological (antiemetics, less emetogenic anaesthesia drugs), non-pharmacological (acupuncture, adequate hydration) and combinations of the above options. For rescue therapy in the case of nausea and vomiting, drugs that have not been previously used in prophylaxis are employed; for second-line therapy- metoclopramide, which should not definitely be used as a first-line treatment in the case PONV starts. The risk of post-discharge nausea and vomiting (PDNV ) in adults is assessed using simplified PDNV risk score, while
for prophylaxis, long-acting drugs are preferred (glucocorticosteroids, anticholinergic drugs, palonosetron, NK-1 receptor antagonists). If required, ondansetron tablets can be prescribed for home treatment.