The incidence and aetiology of post-operative nausea and vomiting in a plastic surgical unit

Low incidence of the oculocardiac reflex and postoperative nausea and vomiting in adults undergoing strabismus surgery

“…In an uncontrolled series of patients from a plastic surgery ward, post-hoe subgroup analyses suggested that children were at higher risk for PONV than adults. 13 If there is a difference in the likelihood of PONV between younger and older patients it may be directly age-related or due to children specific surgical settings which entail a higher risk for PONV (such as ENT surgery, dental surgery and squint repair I4,Is) compared with adults.…”

Postoperative emesis following otoplasty in children

“…The higher than normal incidence of postoperative nausea and vomiting (POW) in patients undergoing otoplasty may be due to disturbances of the vestibular apparatus resulting from stimulation of a reflex mediated through the auriculo-temporal branch of the facial nerve and vagus nerve [3], which may be analogous to vomiting produced by stimulation of 'Aldermans Nerve'. Although infiltration anaesthesia was used in this study, stimulation during surgery or anaesthetic effects still led to a high incidence of emesis in the placebo group.…”

“…However, recent evidence would suggest that this is not the case [ 1,2] and, in particular, certain operative procedures are associated with a high incidence of PONV, for example strabismus surgery and otoplasty (4&50%) [3,4]. Although, droperidol has been used to decrease the incidence of postoperative vomiting following strabismus surgery [5] it may produce marked sedation [6,7] and cause extrapyramidal side effects [8].…”

The effect of low dose midazolam in addition to ondansetron on post-operative nausea and vomiting in laparoscopic cholecystectomy – a comparative study

“…The aetiology of PONV is multifactorial and includes factors related to the characteristics of the patients, the type of surgery, type of anaesthetics and postoperative conditions 2 . Persistent nausea and vomiting may result in dehydration, electrolyte imbalance and delayed discharge. It may also cause tension on suture lines, venous hypertension and increase bleeding under skin flaps and can expose the subject to an increased risk of pulmonary aspiration of vomitus if airway reflexes are depressed form the residual effects of anaesthetic and analgesic drugs 3 .…”