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Reducing postoperative nausea and vomiting

DURHAM, N.C. A Duke University Medical Center anesthesiologist who analyzed studies of postoperative nausea and vomiting (PONV) believes that better communication between physicians and patients would significantly reduce nausea and vomiting as a side effect of surgery.

He advocates that physicians work with each patient to develop a plan to reduce PONV that might include treatments ranging from anti-emetic drugs to stress reduction to acupuncture. Not only would the use of such plans return patients to their everyday lives sooner, he said, it could also significantly reduce health care costs.

Despite decades of advances in surgical technique and improved anesthetic agents, one out of three patients will still experience nausea and vomiting after surgery. Such a condition not only influences patient satisfaction, but can also prolong recovery, lengthen hospital stays and negatively impact the surgery itself.

There are more than 35 million surgical procedures performed each year in the U.S., so PONV is an extremely important health care issue, said Duke anesthesiologist Dr. Tong J. Gan, whose analysis was published in the March 13, 2002 issue of the Journal of the American Medical Association.

It is also an issue that most physicians do not take seriously enough; they see it as a short-term nuisance that will soon pass. However, studies have shown that nausea and vomiting after surgery is the major factor influencing whether or not patients are satisfied with their surgery.

We already know a lot about PONV and new drugs are being developed all the time. It is just a matter of putting it all together, Gan continued. To do better, physicians need to ask the right questions of their patients in order to develop strategies to reduce the chances of it occurring.

The challenge, according to Gan, is identifying all relevant the risk factors whether they be patient characteristics, type of surgery, and method of a
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Contact: Richard Merritt
merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
12-Mar-2002


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