Postoperative nausea

Postoperative nausea and vomiting (PONV) is the phenomenon of nausea, vomiting or retching experienced by a patient in the Post Anesthesia Care Unit (PACU) or 24-hours following a surgical procedure. It is an unpleasant complication that affects about 10% of the population undergoing general anaesthesia each year. Postoperative nausea and vomiting (PONV) is the phenomenon of nausea, vomiting or retching experienced by a patient in the Post Anesthesia Care Unit (PACU) or 24-hours following a surgical procedure. It is an unpleasant complication that affects about 10% of the population undergoing general anaesthesia each year. Emetogenic drugs commonly used in anaesthesia include nitrous oxide, physostigmine and opioids. The intravenous anaesthetic propofol is currently the least emetogenic general anaesthetic. These medications are thought to stimulate the chemoreceptor trigger zone (CTZ). This area is on the floor of the fourth ventricle and is effectively outside of the blood-brain barrier. This makes it incredibly sensitive to toxin and pharmacological stimulation. There are multiple neurotransmitters such as histamine, dopamine, serotonin, acetylcholine, and the more recently discovered neurokinin-1 (substance P). A 2008 study compared 121 Japanese patients who experienced PONV after being given the general anesthetic propofol to 790 people who were free of post-operative nausea after receiving it. Those with a G at both copies of rs1800497 were 1.6 times more likely to experience PONV within six hours of surgery compared to those with the AG or AA genotypes. But they were not significantly more likely to experience PONV more than six hours after surgery.