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Table 2 Initial treatment for PONV by the prophylaxis agent given

From: Anesthesiologists' practice patterns for treatment of postoperative nausea and vomiting in the ambulatory Post Anesthesia Care Unit

  Vignettes with different prophylaxis regimens
  None 5-HT3 5-HT3 & meto 5-HT3 & meto & dexa 5-HT3 & meto & dexa & drop
Pharmacologic treatment:
Ondansetron 53% 22% 23% 23% 23%
Dolasetron 13% 3% 2% 5% 4%
Droperidol 7% 14% 18% 19% 7%
Dexamethasone 8% 15% 19% 2% 3%
Metoclopramide 11% 21% 4% 5% 4%
Promethazine 3% 13% 20% 22% 28%
Prochlorperazine 0% 1% 1% 2% 4%
Diphenhydramine 0% 0% 0% 5% 4%
Intra-muscular ephedrine 1% 4% 4% 5% 5%
Hydroxyzine 1% 2% 2% 5% 4%
Propofol 0% 1% 1% 2% 5%
Scopolamine patch 1% 1% 1% 2% 3%
Granisetron 1% 1% 1% 1% 1%
Other 1% 2% 2% 2% 3%
Total 100% 100% 100% 100% 100%
Other includes: trimethobenzamide, perphenazine, haloperidol, atropine, or midazolam
5-HT3 = 5-HT3-antagonist; meto = metoclopramide; dexa = dexamethasone; drop = droperidol
Non-pharmacologic treatment:
IV fluid bolus 57% 55% 56% 57% 51%
Oxygen nasal cannula 22% 19% 19% 19% 20%
Sniff alcohol swab 6% 5% 7% 7% 6%
Reassure the patient that PONV will pass 1% 3% 1% 1% 1%
Forced air warming 3% 4% 3% 3% 7%
Keep NPO 1% 1% 3% 1% 1%
Acupressure forearm & acupuncture & acustimulation with the ReliefBand 4% 4% 4% 4% 6%
Lay patient flat on gurney 4% 3% 3% 3% 3%
Other 0% 5% 3% 3% 4%
Total 100% 100% 100% 100% 100%
  1. Other includes: encourage emptying of oropharynx/spitting, assure there is no bleeding, transfer to inpatient ward, or add glucose to IV