P
ostoperative nau-
sea and vomiting is
the last thing
patients want to
deal with when
they're recovering from surgery.
Waking up in the PACU feeling
sick can ruin any good feelings
they might have had about a suc-
cessful procedure and the care
your team provided. PONV can
also lead to concerns more seri-
ous than satisfaction scores: pro-
longed post-op stays, unanticipat-
ed hospital admissions, wound
dehiscence, aspiration,
esophageal tears, electrolyte
imbalance and an overall delay in
a return to functional ability.
Thankfully, there are several effec-
tive and economical ways to pre-
vent PONV, especially if you're
willing to think outside the box.
• Nerve blocks and antiemetics.
Narcotics can cause PONV
because they slow bowel function,
which can lead to constipation,
bloating, vomiting and nausea.
Employing regional anesthesia,
which minimizes the use of heavy
narcotics and volatile anesthetics,
immediately eliminates two risk
factors. As a result, patients will
have shorter recoveries, experience less pain and
have little to no nausea.
Anesthesia providers play an important role in
preventing PONV, because they can employ region-
al blocks before surgery begins. They might also
administer antiemetics — metoclopramide,
cyclizine, prochlorperazine, droperidol,
ondansetron or dexamethasone — prior to and dur-
ing surgery, especially to patients who present with
risk factors associated with PONV.
• Aromatherapy. For many years, nurses would
place an alcohol swab under the nose of a recover-
ing patient who was nauseous in an effort to relieve
the queasy feeling, but sweeter smelling options are
now available. Aromatherapy's exact mechanism of
action on the prevention of PONV is unknown, but
N O V E M B E R 2 0 2 0
• O U T P A T I E N T S U R G E R Y . N E T • 4 5
Jennifer Amedio, RN, BSN, CCRN, PCCN, CPAN, CAPA I Houston
PONV Prevention Pays Off
Aromatherapy, antiemetics and regional blocks improve
discharge times and increase patient satisfaction scores.
SWEET SMELL Aromatherapy inhalers offer a blend of four pure and natural essential oils, all of which are known to have
therapeutic effects on nausea.
Jennifer
Amedio
