Despite extensive research regarding risk factors and treatment regimens, postoperative
nausea and vomiting (PONV) has remained a challenge affecting up to 40% of the general
surgical population, underlining the complex nature of this adverse outcome [
[1]
]. In addition to the criteria described by Apfel et al. [
[1]
], contributing risk factors may be anesthesia, patient, or procedure related. Compared
with the general surgical population, patients undergoing bariatric surgical procedures
experience a much higher incidence of PONV, and current enhanced recovery after bariatric
surgery (ERABS) guidelines suggest intraoperative prophylaxis but provide little guidance
for postoperatively administered prophylaxis or treatment [
[2]
]. This article does not address PONV as a result of mechanical upper gastrointestinal
obstruction or other structural complications from the surgical procedure itself,
and nontraditional treatments such as acupuncture or acupressure are only briefly
described.Key words
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References
- Evidence-based analysis of risk factors for postoperative nausea and vomiting.Br J Anaesth. 2012; 109: 742-753
- Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for bariatric surgery.Anesth Analg. 2019; 129: 51-60
- Post-operative nausea and vomiting in bariatric surgery patients: an observational study.Acta Anaesthesiol Scand. 2017; 61: 471-479
- Assessment of postoperative nausea and vomiting after bariatric surgery using a validated questionnaire.Surg Obes Relat Dis. 2020; 16: 1505-1513
- The impact of nausea on post-operative outcomes in bariatric surgery patients.Surg Endosc. 2020; 34: 3085-3091
- Society for Ambulatory Anesthesia: consensus guidelines for the management of postoperative nausea and vomiting.Anesth Analg. 2014; 118: 85-113
- Postoperative nausea and vomiting in bariatric surgery in comparison to non-bariatric gastric surgery.Wideochir Inne Tech Maloinwazyjne. 2019; 14: 90-95
- Prevalence and risk factors for bariatric surgery readmissions: findings from 130,007 admissions in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.Ann Surg. 2018; 267: 122-131
- Factors associated with prolonged anesthesia recovery following laparoscopic bariatric surgery: a retrospective analysis.Obes Surg. 2015; 25: 1024-1030
- Perioperative antiemetic therapy for fast-track laparoscopic bariatric surgery.Obes Surg. 2018; 28: 1296-1301
- Antiemetic prophylaxis and anesthetic approaches to reduce postoperative nausea and vomiting in bariatric surgery patients: a systematic review.Obes Surg. 2020; 30: 3188-3200
- Fourth consensus guidelines for the management of postoperative nausea and vomiting.Anesth Analg. 2020; 131: 411-448
- The combination of haloperidol, dexamethasone, and ondansetron for prevention of postoperative nausea and vomiting in laparoscopic sleeve gastrectomy: a randomized double-blind trial.Obes Surg. 2013; 23: 1389-1396
- Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials.Anesthesiology. 2011; 115: 575-588
- Dexamethasone and perioperative blood glucose in patients undergoing total joint arthroplasty: a retrospective study.J Clin Anesth. 2017; 37: 116-122
- Dexamethasone for postoperative nausea and vomiting prophylaxis: effect on glycaemia in obese patients with impaired glucose tolerance.Eur J Anaesthesiol. 2009; 26: 318-321
- Adverse side effects of dexamethasone in surgical patients.Cochrane Database Syst Rev. 2018; 11: CD011940
- An enhanced recovery program for bariatric surgical patients significantly reduces perioperative opioid consumption and postoperative nausea.Surg Obes Relat Dis. 2018; 14: 849-856
- Multimodal analgesia reduces narcotic requirements and antiemetic rescue medication in laparoscopic Roux-en-Y gastric bypass surgery.Surg Obes Relat Dis. 2013; 9: 975-980
- Opioid-free total intravenous anaesthesia reduces postoperative nausea and vomiting in bariatric surgery beyond triple prophylaxis.Br J Anaesth. 2014; 112: 906-911
- Impact of a prophylactic combination of dexamethasone-ondansetron on postoperative nausea and vomiting in obese adult patients undergoing laparoscopic sleeve gastrectomy during closed-loop propofol-remifentanil anaesthesia: a randomised double-blind placebo-controlled study.Eur J Anaesthesiol. 2016; 33: 898-905
- Ambulatory bariatric surgery.Int Anesthesiol Clin. 2020; 58: 21-28
- Prospective assessment of postoperative nausea early after bariatric surgery.Obes Surg. 2019; 29: 858-861
- The role of aprepitant in prevention of postoperative nausea and vomiting after bariatric surgery.Obes Surg. 2018; 28: 37-43
- Aprepitant’s prophylactic efficacy in decreasing postoperative nausea and vomiting in morbidly obese patients undergoing bariatric surgery.Obes Surg. 2014; 24: 225-231
- Transdermal scopolamine for the prevention of postoperative nausea and vomiting: a systematic review and meta-analysis.Clin Ther. 2010; 32: 1987-2002
- The effectiveness of non-invasive complementary therapies in reducing postoperative nausea and vomiting following abdominal laparoscopic surgery in women: a systematic review.JBI Libr Syst Rev. 2009; 7: 850-907
- A prospective, randomized, double-blind, placebo-controlled study to assess the antiemetic effects of midazolam on postoperative nausea and vomiting in women undergoing laparoscopic gynecologic surgery.Clin Ther. 2005; 32: 1633-1637
- The effectiveness of rescue antiemetics after failure of prophylaxis with ondansetron or droperidol: a preliminary report.J Clin Anesth. 2005; 17: 62-65
- Eliminating postoperative nausea and vomiting in outpatient surgery with multimodal strategies including low doses of nonsedating, off-patent antiemetics: is “zero tolerance” achievable?.Sci World J. 2007; 7: 959-977
- Determination of plasma concentrations of propofol associated with 50% reduction in postoperative nausea.Anesthesiology. 1997; 87: 779-784
- A review of NEPA, a novel fixed antiemetic combination with the potential for enhancing guideline adherence and improving control of chemotherapy-induced nausea and vomiting.Biomed Res Int. 2015; 2015: 651879
- A prospective, randomized, double-blind trial to compare body weight-adjusted and fixed doses of palonosetron for preventing postoperative nausea and vomiting in obese female patients.PLoS One. 2020; 15e0227490
- Supplemental intravenous crystalloids for the prevention of postoperative nausea and vomiting: quantitative review.Br J Anaesth. 2012; 108: 893-902
Article info
Publication history
Published online: August 11, 2021
Accepted:
August 5,
2021
Received:
August 1,
2021
Identification
Copyright
Published by Elsevier Inc. on behalf of American Society for Bariatric Surgery.
