BMJ  2006;333:313-314 (12 August), doi:10.1136/bmj.333.7563.313

Editorial

Postoperative nausea and vomiting

Metaclopramide with dexamethasone works and has few side effects

The first 150 words of the full text of this article appear below.

Fifteen years ago Kapur described postoperative nausea and vomiting as the "big, little problem,"¹ a description that still applies despite the best efforts of doctors and drug companies. In this issue of the BMJ, Wallenborn and colleagues revisit the use of metoclopramide to prevent postoperative nausea and vomiting.² In the United Kingdom, metoclopramide is no longer a popular choice for prophylaxis or treatment. This is because the standard 10 mg dose is not very effective³; metoclopramide has unpleasant side effects such as extrapyramidal symptoms, especially with repeated doses; and it has been supplanted by newer agents that are more expensive but have fewer complications.

The likelihood of postoperative nausea and vomiting is increased by several factors including the type of surgery (for example, laparoscopic, gynaecological, and ophthalmic surgery), certain anaesthetic drugs including volatiles and opioids, patient factors including female sex, a history of postoperative nausea and vomiting, . . . [Full text of this article]

Poole and Royal Bournemouth Hospital, Bournemouth BH7 7DW
(bpsween@aol.com)

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• Carlisle, J. B (2006). Preventing postoperative nausea and vomiting: prevention in context.. BMJ 333: 448-448 [Full text]  

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