Post op Nausea and capsicum plasteris

Postoperative nausea and vomiting (PONV) is an unpleasant complication affecting about a third of the 10% of the population undergoing general anaesthesia each year.

Cause

Emetogenic drugs commonly used in anaesthesia include nitrous oxide, physostigmine and opioids. The intravenous anaesthetic propofol is currently the least emetogenic general anaesthetic.

Management

Because no currently available antiemetic is especially effective by itself, and successful control is often elusive, experts recommend a multimodal approach.

Medications

A Cochrane review found droperidol, metoclopramide, ondansetron, tropisetron, dolasetron, dexamethasone, cyclizine, and granisetron effective for preventing PONV. Carlisle, JB; Stevenson, CA (19 July 2006). "Drugs for preventing postoperative nausea and vomiting.". The Cochrane database of systematic reviews (3): CD004125. doi:10.1002/14651858.CD004125.pub2. PMID 16856030

Alternative medicine

In conjunction with antiemetic medications, at least one study has found that application to the Pericardium Meridian 6 acupressure point produced a positive effect in relieving postoperative nausea and vomiting. "Acupressure Treatment For The Prevention Of Postoperative Nausea And Vomiting" Another study found no statistically significant difference. "Effect of acupressure on postoperative nausea and vomiting in laparoscopic cholecystectomy."

Multimodal therapies for postoperative nausea and vomiting, and pain

http://bja.oxfordjournals.org/content/107/suppl_1/i27.full

Editor's key points

Postoperative nausea and vomiting along with pain are among the major perioperative concerns of most surgical patients and their anaesthetists.
Multimodal approaches to both PONV and pain have been shown to improve treatment efficacy and reduce side-effects for high-risk patients undergoing surgical procedures.
These approaches integrate both pharmacological and non-pharmacological interventions made before operation, intraoperatively, and after operation.

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