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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