The optimum management of nausea and vomiting during and after cesarean delivery.

Journal Article (Journal Article;Review)

Intraoperative and postoperative nausea and vomiting (IONV and PONV) afflict up to 80% of parturients undergoing cesarean delivery with neuraxial anesthesia. Preventing nausea and emesis is a top priority for women undergoing cesarean delivery and is included in the quality of recovery measures and enhanced recovery after cesarean delivery protocols. The majority of known perioperative emetic triggers can be avoided or mitigated by optimizing anesthetic and surgical management. IONV may arise from spinal anesthesia-induced hypotension, intraoperative pain, and medications such as uterotonics and antibiotics. Furthermore, uterine exteriorization and peritoneal irrigation increase IONV risk. Conversely, preventing PONV mainly focuses on optimizing analgesia through an opioid-sparing, multimodal strategy. In addition, combination prophylactic antiemetic therapy should be instituted in this high-risk population to further reduce the risk of IONV and PONV.

Full Text

Duke Authors

Cited Authors

  • Tan, HS; Habib, AS

Published Date

  • December 2020

Published In

Volume / Issue

  • 34 / 4

Start / End Page

  • 735 - 747

PubMed ID

  • 33288123

Electronic International Standard Serial Number (EISSN)

  • 1878-1608

Digital Object Identifier (DOI)

  • 10.1016/j.bpa.2020.04.012


  • eng

Conference Location

  • Netherlands