Well Established PONV Risk Factors

  • Female gender after puberty
  • Childhood after infancy and before young adulthood
  • Non-smoking status
  • History PONV or motion sickness
  • Increased duration of surgical procedures. Each 30 minute increase in surgery time increases baseline PONV risk by 60%
  • Use of volatile anesthetics
  • Use of nitrous oxide
  • Balanced versus total IV anesthetic
  • Large doses greater then or equal to 2.5 mg of neostigmine
  • Administration of opioids intravenously or post-operatively
  • Patients with any of these risk factors should receive antiemetic prophylaxis with a combination of 2 or 3 drugs which has been proven to be most effective. Also be sure your anesthesia care providers are aware of the half life of antiemetics medications with longer half life’s are better suited for ASC patients since they spend less time in the facility and are DC’d home shortly after the procedure.

Source: Outpatient Surgery Magazine