Postoperative nausea and vomiting in children
Authors:
M. Frelich 1,2; J. Divák 1,2; R. Kula 1,2
Authors‘ workplace:
Klinika anesteziologie, resuscitace a intenzivní medicíny FN Ostrava
1; Lékařská fakulta, Ostravská univerzita v Ostravě
2
Published in:
Anest. intenziv. Med., 27, 2016, č. 4, s. 214-221
Category:
Anesthesiology - Review Article
Overview
Prevention and treatment of postoperative nausea and vomiting (PONV) and pain relief belong among the basic pillars of postoperative care in paediatric patients. The precise incidence of PONV in children remains unknown, however it is estimated that the occurrence is double compared to the adult population. According to literature, the incidence of PONV in the paediatric population is 9–42%. The risk factors and predispositions are different from adult patients. The PONV consequences include higher perioperative morbidity (surgical wound dehiscence, bleeding, dehydration, etc.), increased length of stay in the post-anaesthesia care unit (PACU) and increased length of stay in hospital. Currently, multimodal approach to prevention and treatment of PONV is used. It is based on a rational combination of pharmacological and non-pharmacological approaches. The Eberhart scoring system stratifies paediatric patients according to the degree of PONV risk and suggests appropriate prophylaxis or treatment. Apart from PONV risk assessment and choice of pharmacological prophylaxis (if indicated), the incidence of PONV may be further decreased with a suitable choice of anaesthetic techniques: total intravenous anaesthesia (TIVA, applying the anti-emetic effects of propofol) or regional anaesthesia (opioid-sparing effect). There are numerous preparations available, acting through various receptor systems of the CNS: antagonists of the 5-HT3 receptors, D2 receptors and muscarinic receptors, etc. The goal of effective PONV prevention and treatment is the lowest possible incidence of PONV and the highest paediatric patient/parent satisfaction.
Keywords:
postoperative nausea and vomiting – paediatric anaesthesia – ondansetron – droperidol – multimodal approach
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Anaesthesiology, Resuscitation and Inten Intensive Care MedicineArticle was published in
Anaesthesiology and Intensive Care Medicine
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