miércoles, 28 de septiembre de 2016

Más de nausea y vomito / More on nausea and vomiting

Septiembre 28, 2016. No. 2462







Estratificación del riesgo, profilaxis y tratamiento de las náuseas y vómitos postoperatorios
I. Bel Marcoval, P. Gambús Cerrillo
Rev. Esp. Anestesiol. Reanim. 2006; 53: 301-311
PDF 
Nausea y vomito postoperatorios: Un problema simple pero complejo
Postoperative nausea and vomiting: A simple yet complex problem.
Shaikh SI, Nagarekha D, Hegade G, Marutheesh M.
Anesth Essays Res 2016;10:388-96.
Abstract
Postoperative nausea and vomiting (PONV) is one of the complex and significant problems in anesthesia practice, with growing trend toward ambulatory and day care surgeries. This review focuses on pathophysiology, pharmacological prophylaxis, and rescue therapy for PONV. We searched the Medline and PubMed database for articles published in English from 1991 to 2014 while writing this review using "postoperative nausea and vomiting, PONV, nausea-vomiting, PONV prophylaxis, and rescue" as keywords. PONV is influenced by multiple factors which are related to the patient, surgery, and pre-, intra-, and post-operative anesthesia factors. The risk of PONV can be assessed using a scoring system such as Apfel simplified scoring system which is based on four independent risk predictors. PONV prophylaxis is administered to patients with medium and high risks based on this scoring system. Newer drugs such as neurokinin-1 receptor antagonist (aprepitant) are used along with serotonin (5-hydroxytryptamine subtype 3) receptor antagonist, corticosteroids, anticholinergics, antihistaminics, and butyrophenones for PONV prophylaxis. Combination of drugs from different classes with different mechanism of action are administered for optimized efficacy in adults with moderate risk for PONV. Multimodal approach with combination of pharmacological and nonpharmacological prophylaxis along with interventions that reduce baseline risk is employed in patients with high PONV risk.
Keywords: Nausea-vomiting, postoperative nausea and vomiting, postoperative nausea and vomiting prophylaxis, and rescue
Profilaxis y tratamiento de nausea y vomito postoperatorios en los protocolos de recuperación mejorada: declaración de la opinión experta de la Sociedad Americana para la recuperación mejorada
Prophylaxis and management of postoperative nausea and vomiting in enhanced recovery protocols: Expert Opinion statement from the American Society for Enhanced Recovery (ASER).
Perioper Med (Lond). 2016 Mar 2;5:4. doi: 10.1186/s13741-016-0029-0. eCollection 2016.
International experience and evidence-based practices have shown that reduction in variability through use of protocolized perioperative care improves surgical outcomes and reduces costs to patients and healthcare systems. In this series of Expert Opinions, we provide consensus recommendations for the various components of perioperative care to aid with the development of enhanced recovery after surgery protocols.
KEYWORDS: Expert Opinion; Nausea; Prophylaxis; Vomiting
CEEA Veracruz

XIII Congreso Virtual Mexicano de Anestesiología
Octubre a Diciembre 2016

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