Undergoing surgery often shifts focus from the procedure to the recovery. Postoperative nausea and vomiting (PONV) can complicate this process, turning a straightforward recovery into a challenging one. 

Effective management of PONV is crucial for a smoother, more comfortable recovery. This blog provides practical tips to minimise these symptoms and make your postoperative journey as pleasant as possible.

What causes postoperative nausea and vomiting?

Postoperative nausea and vomiting are common after surgery, affecting up to 30% of patients. This condition can vary from mild nausea to severe, persistent vomiting, potentially leading to dehydration, delayed recovery, and extended hospital stays. The causes of PONV are diverse and can include the type of surgery performed, the anaesthesia used, and the patient’s susceptibility.

What are the best strategies for prevention of postoperative nausea and vomiting?

1. Preoperative consultation 

Discuss any previous nausea or vomiting with your anesthesiologist to tailor preventive strategies. This personalised approach helps reduce the risk of PONV.

• Share a detailed history of nausea.
• Work with your anesthesiologist to customise your anaesthesia plan.

2. Medication review

Review your medications with your healthcare provider before surgery. Some medications can increase PONV risk, so adjusting them can help manage symptoms.

• Identify and adjust high-risk medications.
• Check for potential medicine interactions with anaesthesia.

3. Hydration

Stay well-hydrated before surgery. Dehydration can worsen nausea, so drink plenty of fluids leading up to your procedure.

• Drink ample fluids in the days before surgery.
• Avoid caffeine and alcohol.

How can anaesthetic management help prevent postoperative nausea and vomiting?

1. Anesthetic techniques

Discuss anaesthesia options with your anesthesiologist. Choosing anaesthetics with a lower risk of nausea can help prevent PONV.

• Opt for anaesthetics known for lower nausea risk.
• Discuss different agents' effects on nausea.

2. Antiemetic medications

Antiemetic medications can be administered during surgery to prevent nausea. These medications target nausea receptors effectively.

What immediate steps can help manage postoperative nausea and vomiting?

1. Gradual diet

Reintroduce food gradually post-surgery. Start with clear liquids and move to bland foods to avoid overwhelming your stomach.

• Begin with clear liquids and small amounts of water.
• Gradually add bland, easy-to-digest foods.

2. Positioning

Use a propped-up position rather than lying flat to reduce nausea. This helps prevent acid reflux and makes you more comfortable.

• Sit up or lie propped up, not flat.
• This can help with nausea and acid reflux.

3. Controlled breathing

Practice deep, slow breathing to help soothe your nervous system and manage nausea. This technique is useful during early recovery.

• Engage in deep breathing exercises.
• This can provide immediate relief from nausea.

4. Environmental Factors

Ensure a comfortable recovery environment by avoiding bright lights, strong smells, and loud noises.

• Keep your space calm and well-ventilated.
• Use air fresheners or open windows to reduce unpleasant odours.

What are effective long-term strategies for managing nausea?

1. Medications

If nausea continues beyond the initial recovery phase, you may need additional antiemetic medications. Consult with your surgeon to explore other options. While the Akynzeo Capsule, containing the active ingredients netupitant and palonosetron, is effective for many, different medications may offer better results depending on your specific symptoms.

• Discuss persistent nausea with your healthcare provider.
• Explore alternative antiemetic medications if needed.

2. Acupressure and acupuncture

For some patients, alternative therapies such as acupressure or acupuncture can offer additional relief. These methods work by stimulating specific points in the body that may help alleviate nausea, complementing traditional treatments.

• Consider acupressure bands or acupuncture as supplementary treatments.
• These techniques might provide additional comfort and relief.

3. Ginger and peppermint

Natural remedies like ginger and peppermint are well-known for their anti-nausea properties. Ginger tea and peppermint oil are traditional remedies that can soothe gastrointestinal discomfort and support recovery.

• Use ginger tea or peppermint oil to alleviate nausea.
• You can include these natural remedies in your recovery plan for added relief.

4. Avoid strong odors

Strong smells can trigger or worsen nausea, so it’s wise to avoid them. To maintain a fresh and pleasant atmosphere in your recovery space, use air fresheners or keep windows open to minimise unpleasant odours.

• Avoid exposure to strong cooking smells and other potent odours.
• Use air fresheners or open windows to keep the recovery area fresh.

Importance of follow-up care

Postoperative nausea and vomiting management doesn’t end with discharge from the hospital. Schedule follow-up appointments with your surgeon to assure that your recovery is on track and discuss any lingering issues with nausea. 

Wrapping up

Recovering from surgery involves more than just healing from the procedure itself; it's about ensuring a smooth, comfortable journey through the postoperative phase. By actively managing and preventing postoperative nausea and vomiting with the right strategies and support, you set yourself up for a quicker, more pleasant recovery. 

From personalised preoperative consultations to practical, immediate steps and long-term remedies, these approaches will help you focus on what matters most: getting back to your life with minimal discomfort. Embrace these strategies and remember a proactive and informed approach can turn your recovery into a more positive experience.