[Update PO(N)V-What is new in the prophylaxis and treatment of postoperative nausea and vomiting?]

Abstract

Postoperative nausea and vomiting (PONV) is defined as the joint or individual occurrence of nausea, retching and vomiting within 24-48h after an operation. The peripheral and central nervous systems are involved in the development of PONV. The pathogenesis of PONV is multifactorial. Patient-related, anaesthesia-related and surgery-related risk factors can be present. Some of the risk factors for PONV were combined to form PONV risk scores (e.g., the simplified risk score for predicting postoperative nausea and vomiting from Apfel et al.), with the help of which the risk of PONV can be estimated with a sensitivity and specificity of 65-70%. For certain collectives specialised PONV risk scores should be prioritised. The antiemetic strategy is divided into three areas: modification of the anaesthetic procedure, pharmacological and nonpharmacological interventions. These can be applied individually or combined in the sense of a multimodal PONV prophylaxis.