What are the patient risk factors? (6)
What decreases risk?
Female Young Previous Hx of PONV Obesity Motion sickness sufferer Pre-operative anxiety
Smoking
What are the anaesthetic risk factors? (8)
Opiods NO Etomidate Ketamine Volatile gases GA Inhalation compared to intubation Hypotension
What are the surgical risk factors? (5)
Middle ear surgery Abdominal surgery Genitourinary surgery Ophthalmic surgery Neurosurgery
What are the post-operative risk factors? (5)
Dehydration Electrolyte imbalances Metabolic imbalances Hypotension Hypoxia
Rx?
Prophylactic ondansetron (SHT3 antangonist) and dexamethasone Acupuncture point P6 – as effective as antiemetics.
Other anti-emetics?
Anti serotonergics: Ondansetron
Anti dopaminergics: Metoclopramide
Antihistaminics: Cyclizine