Post discharge nausea vomiting

Postdischarge Nausea and Vomiting

As the number of surgeries performed on an outpatient basis continues to grow, there is increasing interest in using antiemetic agents to prevent and treat postdischarge nausea and vomiting (PDNV).

Because outpatient procedures are typically less invasive and shorter in duration than inpatient

procedures, the relatively lower exposure to emetogenic inhalational anesthetics and opioids predicts a relatively lower incidence of PONV in the PACU.

However, a study in 2170 ambulatory patients in the United States found that the incidence of nausea and vomiting after discharge from the hospital was 37%, even after intraoperative prophylaxis with ondansetron or dexamethasone.

PDNV is particularly a concern because it occurs when patients no longer have access to fast-acting intravenous rescue treatment, and PDNV limits their ability to tolerate oral antiemetics. Ideal antiemetics for PDNV should have a long duration of action with a safe side effect profile, such as palonosetron, TDS, aprepitant, and rolapitant. However, further studies are required to investigate the absolute and relative value of these and other antiemetics in the postdischarge setting.

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