The cure for postoperative vomiting

Abstract

The routine use of drugs to prevent postoperative vomiting is hard to justify. This is not to say, however, that the possibility of vomiting should be given no thought until the patient is actually sick. Postoperative vomiting can be minimized, or prevented entirely, by intelligent ward care. Prevention and cure go hand in hand in the general management of the patient. When vomiting persists the day after operation, a full examination of the patient should be made to exclude a serious cause such as intestinal obstruction, acute dilatation of the stomach, acute gastric ulceration, uraemia, raised intracranial tension, or digitalis intoxication. Cerebral ischaemia is a common cause of nausea, and should always be suspected. Serious vomiting due to the anaesthetic agent is nowadays uncommon, but vomiting due to morphine and other analgesics is common. A general plan for the postoperative management of patients is outlined. If vomiting is troublesome, the phenothiazine drugs are nearly always effective: preferences vary, but perphenazine may be recommended. The new non-phenothiazine drug trimethoxy-benzamide (Tigan) shows promise. © 1963 John Sherratt and Son.