Safest and cheapest antiemetics should be used first for postoperative nausea

Drugs for reducing postoperative nausea and vomiting are equally effective, and so which treatment patients receive should be guided by safety and affordability.

More than 75 million surgical patients worldwide are anaesthetised each year. Without treatment a third will have postoperative nausea, vomiting, or both. The relative benefits of prophylactic antiemetic interventions given alone or in combination, however, remain unknown.

In a randomised controlled trial comparing combinations of six different antiemetics a team of researchers led by Dr Christian Apfel of the Julius-Maximilians University in Würzburg, Germany, enrolled 5199 patients from 28 different centres who were scheduled to undergo elective surgery under general anaesthesia and who had a high risk of postoperative nausea and …