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Antiemetic agents

Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care, Page: 445-451
2015
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Book Chapter Description

Fifty-two percent of all surgical patients will experience postoperative nausea and vomiting (PONV) when no antiemetics are used. Risk factors include female sex, nonsmoker, having a history of motion sickness, or PONV. Anesthetic risk factors include not receiving a total intravenous anesthetic (TIVA), receiving opioids, exposure to nitrous oxide, and the length of the anesthetic. Class/type of antiemetic or not using a triggering anesthetic technique was associated with the same decrease in PONV, and to each was attributed a 26 % decrease in PONV. Additionally, patients are willing to pay between $56 and $100 out of pocket to receive an antiemetic that is completely effective. Neostigmine has been found to be a triggering agent at a dose above 2.5 mg in some studies, but other studies have failed to show any correlation between neostigmine and PONV. A recent meta-analysis showed that inhaled isopropyl alcohol was more effective than placebo, but less effective than standard antiemetics.

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