Post-operative Nausea and Vomiting
Post-operative nausea and vomiting (PONV) is nausea, retching or vomiting after a procedure or anaesthetic. Risk varies with the person, procedure, anaesthetic technique and medicines used during recovery.
Key takeaways
- Women, non-smokers, people with a history of motion sickness or previous PONV, and those who will need opioid pain relief after the procedure are all considered higher-risk.
- Timing after anaesthesia, vomiting frequency, hydration and signs of bleeding, ileus or another complication determine the response.
- Antiemetic medicines are the main treatment.
The listings below do not distinguish an anaesthetic effect from a surgical complication; antiemetic choice depends on risk factors, heart rhythm and medicines already given.
Who is at higher risk
Several factors raise the likelihood of PONV. Longer surgeries and certain procedure types, such as laparoscopic, gynaecological, and ear surgeries, also increase the chance of symptoms.
How it is managed
Serotonin 5-HT3 receptor antagonists such as ondansetron may be used before or after surgery to reduce nausea and vomiting. Higher-risk patients may receive medicines from more than one class. Anaesthetic technique, opioid exposure, hydration and the cause of ongoing vomiting also affect management; catalogue entries under digestive health are not a personal recovery plan.
When to seek urgent care
Contact the surgical team for repeated vomiting, inability to keep fluids down, reduced urine, worsening abdominal pain or wound problems. Vomiting blood, severe swelling, fainting, confusion, chest pain or breathing difficulty needs urgent assessment.