Outpatient Surgery Magazine

Special Edition: Pain Management - March 2021 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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M y career as a nurse anesthetist recently began at two plastic surgery centers, where I knew I'd face significant challenges in managing PONV. Rates of the relatively common complication are often much higher after plastics cases (35% to 40%) than after other types of procedures (25% to 30%). Instead of waiting to treat nauseous patients postoperatively, I went on the offensive by using a personal protocol that produced immediate positive results (see "A Proactive Approach to PONV Prevention"). Incidence of PONV among my patients has noticeably declined and PACU nurses report that patients feel better, faster. As a result, patient satis- faction at the surgery centers has significantly improved. I've found out from firsthand experience that it's important to prevent PONV, not treat it. Doing so requires a perioperative strategy that will achieve optimal outcomes for happier patients. Understand the risks Your first step in preventing PONV is identifying patients who are most at risk. Generally, women, specifically younger women, are at higher risk, as are non-smokers and anyone with a known history of PONV or motion sickness. The type and duration of the procedure also plays a key role in the likeli- hood of a patient developing PONV. Intraabdominal or gynecologic procedures are believed to cause more vomiting and nausea than other surgeries. Lengthier procedures lead to longer exposure to anesthesia gases, and volatile anesthetics and nitrous oxide can cause nausea. Of course, when 2 6 • S U P P L E M E N T T O 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 • M A R C H 2 0 2 1 Ryan Wade, CRNA I Dallas PONV Prevention Boosts Patient Satisfaction Efforts to eliminate that queasy feeling improve the quality of care you provide. TOUGH TO STOMACH Patients will remember feeling sick long after surgery, regardless of how well the procedure went. Pamela Bevelhymer

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