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In this episode, episode 42, I discuss Post-op Nausea and Vomiting (PONV). I discuss risk factors, complications, treatment and prevention and side effects.
CME: https://earnc.me/31KodT
Outline by April Liu: Outline
UPDATE April, 2018: In this episode I mention that the evidence is not good for Midazolam in preventing PONV. However, a good friend and colleague, Dr. Michael Grant, did a nice meta-analysis of available trials which concluded that it actually does work fairly well. Check out his study:
Grant MC, Kim J, Page AJ, et al. The Effect of Intravenous Midazolam on Postoperative Nausea and Vomiting: A Meta-Analysis. Anesthesia & Analgesia: 2016:122(3); 656–663.
Is there evidence regarding dexametadone be effective only for prevention of PONV and not effective for treatment/ rescue? All the other drugs are good for both situations?
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Hi Gabriela,
Thanks for the question. I think you’re asking about dexamethasone (decadron) which is definitely effective for prevention of PONV. It can also be used as a treatment/rescue but is unlikely to have as much of an immediate effect due to its mechanism of action. If you were asking about dexmedetomidine (precedex) there is also some evidence for prevention of PONV with use of precedex, probably due to reduced post-op opioid use. I hope that helps.
Best,
Jed