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it impacts the olfactory bulb, where impulses are processed and transmitted to the limbic system of the brain, and then to the central nervous system. Before adding aromatherapy to our PONV-prevention protocols, we decided to test its effectiveness on more than 300 patients. When patients arrived in PACU, they were asked to rate their nausea from 0 to 10, with 10 being the worst. After three to five minutes of using aromatherapy inhalers, patients were asked to again rate their nausea. The average pre-intervention score was 6.11; the average post-intervention score was reduced to 2.82. We also found that 37% of patients who were treated with aromatherapy did not need any additional treatment. In fact, we also saw a significant reduction in the use of antiemetics prescribed because of aromatherapy. In three months, we were able to save 43 doses of promet- hazine and 34 doses of ondansetron. Now, if a patient wakes up feeling nauseous, we ask them if they would like to try aromatherapy and have found that many are willing. We lay the aromatherapy inhaler on the chests of patients who are still groggy from surgery, but more alert patients can hold it right up to their noses and breathe in the scent. The inhaler is a blend of four pure and natural essential oils — lavender, peppermint, ginger and spearmint — all of which are known to have thera- peutic effects on nausea. Some of the perks of the aromatherapy inhalers are that they're disposable and the scent lasts for up to two hours. The cost per inhaler is only about $2. Nausea is one of those tricky things to treat because it comes and goes, but the convenience of the inhaler lets patients take it home with them once they're discharged to use again if they start to feel queasy. • Acupressure. This ancient healing art based on the traditional Chinese medicine can help relieve tension and nausea. Acupressure bands are popular with pregnant women, especially early in their preg- nancies. The bands apply pressure to the pericardi- um 6 (PC6) point near the wrist and can provide comparable effects to traditional antiemetics that are used in PONV prevention. 4 6 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 2 0 Ms. Amedio (jmamedio@houstonmethodist.org) is a nurse at Houston (Texas) Methodist Willowbrook Centerfield. • Relaxing sounds. Music has the ability to improve the body's immune system function and reduce stress. Patients who listen to music perceive their PACU experience as significantly more pleas- ant than the patients who do not listen to music and report significantly less pain and less distress. We play soft music in the recovery room and patients often tell me it's very soothing. Effective, easy and inexpensive Depending on your patient's total number of risk factors, the occurrence of PONV can be as high as 87%. Research has shown women, nonsmokers, and patients who are administered volatile anes- thetics and post-op opioids are at increased risk. Abdominal surgery is another risk factor because surgeons are working near nerves of the stomach. The high incidence of PONV following open abdominal or intra-abdominal laparoscopic surgery may be due to the release of serotonin, also known as 5-hydroxytryptamine (5-HT). It plays a key role in the development of PONV in many situations, because close to 90% of the body's serotonin is made in the digestive tract. Patients are aware of alternative therapies and are interested in what they offer. The great thing about using these therapies to manage PONV risk factors is they're easy to administer and inexpen- sive. They're a great way to give your nursing staff more autonomy, which promotes better patient out- comes. It is important to educate your staff and to let them witness the effectiveness of these treat- ments. If they can see that they are beneficial to the patient, they'll be more receptive to adding them to their repertoire. OSM Patients are aware of alternative therapies and are interested in what they offer.