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Postoperative Nausea and Vomiting

Approximately twenty to thirty percent of patients are at risk of experiencing postoperative nausea and vomiting (PONV) following surgery and anesthesia. Throughout your surgical experience, Northeastern Anesthesia Services practitioners  use expertise and administer medication  to minimize the risk of these unpleasant side effects.  They will make specific interventions that may alleviate or eliminate PONV.

Overcoming Patient Risk Factors for Postoperative Nausea and Vomiting (PONV)

The preoperative interview with the anesthesiologist is an important first step in quantifying the risks of nausea and vomiting following surgery.  During the interview, your anesthesiologist will discuss your upcoming procedure, your history with previous anesthetics, and options for anesthesia and postoperative pain control.  Women are at increased risk for PONV and the anesthesiologist will also inquire about factors that are known to increase the risk of PONV such as a prior history of postoperative nausea and vomiting, motion sickness, and migraine headaches.  The nature and expected duration of your surgery may also play a role in your risk for these adverse effects.  All of this information will allow your anesthesiologist to assess your risk for PONV and tailor a specific perioperative plan to minimize this risk.  

Overcoming Procedural Risk Factors for Postoperative Nausea and Vomiting (PONV)

Postoperative nausea and vomiting occurs most frequently with procedures performed under general anesthesia.  Abdominal surgery and procedures of the inner ear are known to have a higher incidence of PONV.  If your procedure requires general anesthesia, your anesthesiologist will administer one or more prophylactic medications during your surgery to minimize the risk of subsequent nausea and vomiting.  For patients at highest risk, the anesthesiologist will choose a specific combination of anesthetic agents which have been associated with a reduced risk of postoperative nausea and vomiting.

How Else Do NEA’s Board Certified / Board Eligible Anesthesiology Specialists Prevent Postoperative Nausea and Vomiting (PONV)?

Many surgical procedures may be performed with other types of anesthesia, including spinal, epidural, regional (“nerve blocks”), and local anesthesia.  When applicable, these alternatives to general anesthesia may be preferable for those patients who are at the highest risk for postoperative nausea and vomiting.  Many patients who prefer to be asleep during their procedure may be administered a sedative called Propofol  which, in addition to their primary anesthetic, may actually reduce the risk for PONV.

In the recovery room your anesthesiologist will ensure that you receive adequate pain relief with medications including narcotics such as morphine, hydromorphone, oxycodone, and hydrocodone.   One of the most common side effects of these analgesics is nausea and vomiting.  Your anesthesiologist will order additional medications to treat nausea which may result from these pain medications.  Toradol, a pain medicine in the same family as Motrin, can reduce the need for narcotics and may be used to help relieve pain without contributing to stomach upset.

Although nausea and vomiting is often associated with the surgical postoperative period, your anesthesiologist will work with you to minimize this risk by making appropriate interventions throughout your surgical experience.


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