Postoperative Nausea and Vomiting in Paediatric Anaesthesia

Özet

Postoperative nausea and vomiting (PONV) is a common complication in paediatric anaesthesia and is a source of significant morbidity. Variousindependent risk factors have been implicated in the development of paediatric PONV, including higher pain scores postoperatively, the useof opioids for pain management and the use of volatile anaesthetics for the maintenance of anaesthesia. This review of the current literatureregarding the prevention and treatment of paediatric PONV is based on a search of the PubMed database, which identified published clinicaltrials, systematic reviews and meta-analyses. While the occurrence of PONV in many cases is difficult to avoid entirely, the risk can be mitigatedby the use of multimodal nonopioid analgesic regimens, total intravenous drugs in favour of volatile anaesthetics and an appropriate regimenof prophylactic pharmacotherapy. Frequently administered drug classes for the prevention of PONV include corticosteroids, 5HT3 antagonistsand anticholinergics. The clinical use of the findings in the literature may help to reduce the occurrence of PONV in children. In this review,we provide comprehensive and updated information on the risk factors contributing the occurrence of PONV in children, outline the currentopinion on the drugs that are commonly used for management and provide an overview of the guidelines that are used to help establish theprophylaxis and treatment of paediatric PONV.