Clinical Care Guidelines for Postoperative Nausea and Vomiting: Utilization of Best Evidence

2.50
Hdl Handle:
http://hdl.handle.net/10755/156380
Type:
Presentation
Title:
Clinical Care Guidelines for Postoperative Nausea and Vomiting: Utilization of Best Evidence
Abstract:
Clinical Care Guidelines for Postoperative Nausea and Vomiting: Utilization of Best Evidence
Conference Sponsor:Sigma Theta Tau International
Conference Year:2005
Author:Ontoy, Maria Teresa Tet, BSN, RN
P.I. Institution Name:Christus St. Joseph Hospital
Title:Clinical Nurse
Co-Authors:Shyang-Yun P. K. Shiao, PhD, RN, FAAN
At many as 90% of patients could experience postoperative nausea and vomiting (PONV). Preventing PONV could be significant for care outcomes for early recovery, shorter hospital stay, and saving care costs. PONV involves stimulation of pathophysiologic pathways including vomiting center in the medulla, vestibular neurofibers, afferent visceral parasympathetic fibers, and the chemoreceptor trigger zone. Interventions to treat PONV include pharmacological, non-pharmacological, and complementary treatments. The choices of anti-emetic drugs depend not only on the patient status and the severity of PONV, but also on the potential adverse side effects and available routes of administrations for therapies. Five major categories of drugs include serotonin antagonist (longer lasting with fewer adverse effects), dopamine antagonist (for mild and moderate PONV), antihistamine (blocking histamine type-1 receptors for vestibular apparatus, good for ear surgeries), Phenergan (for motion sickness affecting vestibular apparatus when patients are transferred between units), and dopamine (higher dose for anxiety and agitation). A recent meta-analysis of 17 trials on combination therapy with multiple drugs indicated the need for more severe patients. Non-pharmacological interventions for PONV include dietary and behavioral interventions. Clear liquid diet before the surgery and diet of easy-for-digestion are better choices with relaxing meal times. Relaxation and music therapies reduced PONV. The most effective alternative treatments include acupressure and acupuncture therapy on Pericardium 6 meridian point. There is a growing body of literature on other complementary therapies including ginger, peppermint, supplemental oxygen, isopropyl alcohol inhalation, intravenous fluid administration, slow movement, repositioning, deep breathing, cool washcloths, and mouth care. Complementary therapies are inexpensive and some are every effective, thus carry great promises for future research and practice. A clinical care guideline in a modern surgical unit will be presented including preoperative and postoperative assessment for PONV based on the best evidence to improve care outcomes.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleClinical Care Guidelines for Postoperative Nausea and Vomiting: Utilization of Best Evidenceen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156380-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Clinical Care Guidelines for Postoperative Nausea and Vomiting: Utilization of Best Evidence</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Ontoy, Maria Teresa Tet, BSN, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Christus St. Joseph Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">tetontoy@hotmail.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Shyang-Yun P. K. Shiao, PhD, RN, FAAN</td></tr><tr><td colspan="2" class="item-abstract">At many as 90% of patients could experience postoperative nausea and vomiting (PONV). Preventing PONV could be significant for care outcomes for early recovery, shorter hospital stay, and saving care costs. PONV involves stimulation of pathophysiologic pathways including vomiting center in the medulla, vestibular neurofibers, afferent visceral parasympathetic fibers, and the chemoreceptor trigger zone. Interventions to treat PONV include pharmacological, non-pharmacological, and complementary treatments. The choices of anti-emetic drugs depend not only on the patient status and the severity of PONV, but also on the potential adverse side effects and available routes of administrations for therapies. Five major categories of drugs include serotonin antagonist (longer lasting with fewer adverse effects), dopamine antagonist (for mild and moderate PONV), antihistamine (blocking histamine type-1 receptors for vestibular apparatus, good for ear surgeries), Phenergan (for motion sickness affecting vestibular apparatus when patients are transferred between units), and dopamine (higher dose for anxiety and agitation). A recent meta-analysis of 17 trials on combination therapy with multiple drugs indicated the need for more severe patients. Non-pharmacological interventions for PONV include dietary and behavioral interventions. Clear liquid diet before the surgery and diet of easy-for-digestion are better choices with relaxing meal times. Relaxation and music therapies reduced PONV. The most effective alternative treatments include acupressure and acupuncture therapy on Pericardium 6 meridian point. There is a growing body of literature on other complementary therapies including ginger, peppermint, supplemental oxygen, isopropyl alcohol inhalation, intravenous fluid administration, slow movement, repositioning, deep breathing, cool washcloths, and mouth care. Complementary therapies are inexpensive and some are every effective, thus carry great promises for future research and practice. A clinical care guideline in a modern surgical unit will be presented including preoperative and postoperative assessment for PONV based on the best evidence to improve care outcomes.</td></tr></table>en_GB
dc.date.available2011-10-26T14:43:34Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T14:43:34Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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