Guideline for the management of postoperative nausea and vomiting.

OBJECTIVE: To provide recommendations for the management of postoperative nausea and vomiting (PONV), which may affect as many as 30% of patients. METHODS AND EVIDENCE: Medline, PubMed, and the Cochrane Database were searched for articles published in English from 1995 to 2007. Recognizing that we must work as a team to optimize the care of our patients perioperatively, this guideline was written in partnership with anaesthesiologists. OPTIONS: The areas of clinical practice considered in formulating this guideline are prevention and prophylaxis, treatment, both medical and alternative, and patient education. OUTCOMES: Implementation of this guideline should optimize the prevention of and prophylaxis against PONV and the prompt treatment of women who suffer from PONV following gynaecologic surgery. Increased awareness of options for management should help minimize the effects of PONV. BENEFITS, HARMS, AND COSTS: PONV results not only in increased patient discomfort and dissatisfaction but also in increased costs related to length of hospital stay. Cost of medications to prevent and treat PONV must be weighed against improved surgical experience for the patient and decreased costs to the system. VALUES: Recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care.