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LETTER TO THE EDITOR

Avoiding Emetogenic Triggers in the First Place Is More Effective than Using Antiemetics

Department of Anesthesiology; Duke University Medical Center; Durham, North Carolina; gan00001{at}mc.duke.edu

In Response:

The interpretation by Friedberg that the consensus panel’s emphasis was "heavily biased in favor of antiemetic therapy"1 is not consistent with the published guidelines: the panel affirms that reducing baseline risk factors are important and constitute effective strategies in reducing the risks for developing postoperative nausea and vomiting (PONV).

In the published consensus,2 Guideline 1 recommends the assessment of risks for PONV. Guideline 2 outlines strategies to reduce the baseline risks. Among the recommendations include the use of regional anesthesia with local anesthetics as well as the use of local anesthetic infiltration to reduce intraoperative and postoperative opioid requirements. This is followed by Guideline 3, which discusses the options for antiemetic pharmacotherapy. The panel believes this is a logical sequence for managing patients to prevent PONV.

REFERENCES

1. Barry L. Friedberg. Avoiding emetogenic triggers in the first place is more effective than using antiemetics. Anesth Analg 2008;106:1921–2[Free Full Text]
2. Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, Hooper VD, Kovac AL, Kranke P, Myles P, Philip BK, Samsa G, Sessler DI, Temo J, Tramèr MR, Vander Kolk C, Watcha M; Society for Ambulatory Anesthesia. Society for Ambulatory Anesthesia Guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2007;105:1615[Abstract/Free Full Text]

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gan, T. J. Articles by Watcha, M. Search for Related Content PubMed Articles by Gan, T. J. Articles by Watcha, M.