Post op nausea and vomiting Flashcards
1
Q
Consequences of N and V
A
aspiration pneumonia dehydration oesophageal injury increase bleeding beneath skin flaps delay in mobilisation electrolyte abnormalities acid base disturbances wound dehiscence interference with drug absorpiton
2
Q
consequence - life
A
- discomfort, distress
- fear of further surgery
- delyed discharge
- delay return to work
3
Q
Pre-op factors
A
- anxiety
- absence of food
- presence of food
- delayed gastric emptying
females at higher risk
menstruation increases risk
peak - 11-14
decreases in older age
obestiy
prev N&V
motion sickness
history of migraine
4
Q
Anesthetic related factors
A
- premedication with opiods - increased PONV
- inhaled agents cause N&V
- neostigmine (increases gastrointestinal motility and N&V)
-hypotension, regional nerve block
5
Q
surgical factors
A
intra-abdominal is main one
6
Q
Post op factors
A
post op pain
opiods
movement, diziness, postrual hypotension
7
Q
Management
A
non-drug measures
prophylaxis with anti-emetics
treatment
8
Q
Mediators in mediating the emetic response
A
-dopaminergic D2, cholinergic muscarinic, histaminic serotonergic
Anticholinergics antihistamins - cyclizine Phenothiazines butyropehnoes substitude bezamines 5-ht3 receptor anatomis steroids - dexamethosone
