POST OP NAUSEA -which drug do you like?

KR · Jul 30, 2007

When I had surgery the anesthesists always gave me something and I never had post op nausea.
So, whats your opinion?

Before I even read the post of yours, just reading the title, that instantly came to mind. If more anesthesia folks would pre-medicate for n/v then patients would suffer less and be more comfortable.

Dolce, RN · Jul 30, 2007

For many patients post-op nausea and vomiting is worse than the pain. I agree with you--phenergan knocks people out, Zofran doesn't really work that great, neither does Reglan... Scopalamine pre-op works very well for PONV but is not used that widely.

In my opinion, until we have a "wonder drug" that actually eliminates nausea we will have to use other techniques for controlling it. The first one being to hold off on eating until several hours after surgery. Some patients are so insitant on eating right after surgery and the stuff they want is horrible. Eggs? Hamburgers? Milkshakes? Yikes! That's just asking for trouble. I always give people ice water and crackers and thats it unless they feel like juice or 7-up, coffee etc. There is no need to rush to advance the diet until anesthesia has worn off more.

deeDawntee, RN · Jul 30, 2007

I find that Anzamet is quite effective.

TazziRN, RN · Jul 30, 2007

I've always been premedicated with Zofran and Reglan, and it's never worked for me.....only because it wasn't until the last surgery that we figured out it was the morphine causing it. Apparently I'm really sensitive to that. Once I had morphine on board, nothing worked except for droperidol. It's not a popular drug, though, because it sedates even more than Phenergan does.

montanaladi · Jul 30, 2007

We have had some surgeons use meclizine or antivert with some success, I like droperidal but it seems to not be used that much anymore. Anzemet works too.

Haunted · Jul 30, 2007

12.5 of dilaudid not only soothes N/V, it also stops that post op "shiver" and keeps your post op patient comfortable but arousable. Ask your anesthetist.

kkaz_17 · Jul 30, 2007

Our new orthopedic orders call for Reglan every 6 hours, and Zofran every 8 hours for about the first 48 hours post op. I think it would probably work except that those same orders have us giving PO meds as soon as they get on the floor, and a lot of times these patients don't have bowel tones. I do believe that we see less post op nausea this way then we did before though.

brwneyegal · Jul 30, 2007

I have n/v after every surgery no matter what. I tell them ahead of time, I do not know what they give me but I still get sick. When I had my gall bladder surgery I had to stay another day because of n/v finally they gave me phenergan IM. It hurt like the dickens but it worked for the n/v. Problem is it still hurt a few days later where I got the IM injection.

EmmaG, RN · Jul 30, 2007

We have had some surgeons use meclizine or antivert with some success, I like droperidal but it seems to not be used that much anymore. Anzemet works too.

We stopped using droperidol because of the cardiac risk. It did seem to work, though.

http://www.fda.gov/bbs/topics/ANSWERS/2001/ANS01123.html

oMerMero · Jul 30, 2007

12.5 of dilaudid not only soothes N/V, it also stops that post op "shiver" and keeps your post op patient comfortable but arousable. Ask your anesthetist.

I think you are referring to demerol rather than dilaudid.

bettyboop · Jul 30, 2007

Have suffered PONV previous 6 suguries but on my 7th was given zofran 8mg IV on induction what a difference it made no nausea or vomiting up and about within a couple of hours and personaly speaking i required much less post op analgesia as well.