Perioperative management of patients with postoperative nausea and vomiting (PONV) risks

Postoperative nausea and vomiting (PONV) is a common distressing symptom for patients undergoing surgery and anaesthesia, with incidence ranging from 30% in the general population up to 80% in the high-risk cohort. PONV increases patient dissatisfaction, with additional surgical and anaesthetic implications such as aspiration, wound dehiscence and raised intracranial pressure This article highlights multifactorial aetiologies of PONV including patient, anaesthetic and surgical related factors. Neuropharmacology including activation of various receptors (dopaminergic, muscarinic, serotonergic) and cranial nerves VIII (acoustic-vestibular), IX (glossopharyngeal) and X (vagus nerve) is discussed. The most up-to-date PONV management and novel therapies are also discussed after literature review.