Overview
Postoperative vomiting (POV) is a common complication following surgical procedures, particularly in pediatric patients, often impacting recovery and necessitating additional medical interventions. 12Diagnosis
Key Diagnostic Criteria: Presence of vomiting following surgery.
Recommended Tests: Hemogram parameters including platelet count (PLT), mean platelet volume (MPV), and MPV/PLT ratio may aid in predicting risk in pediatric patients 1.
Grading: No specific grading system mentioned; clinical assessment and patient history are crucial.Management
First-Line Treatments: Regional analgesia techniques, particularly ilio-inguinal block, can reduce POV incidence 2.
Adjunctive Treatments:
- Intravenous (i.v.) anaesthesia with ketamine and propofol showed decreased POV compared to inhalation anaesthesia with sevoflurane 2.
- Antiemetic drugs are commonly used but specific drug classes and doses are not detailed in the provided abstracts.Special Populations
Pediatrics: Platelet count, MPV, and MPV/PLT ratio can predict POV risk in children undergoing deep sedation 1. Intravenous anaesthesia techniques may be more effective in reducing POV compared to inhalation methods 2.
Comorbidities: No specific guidance provided for other special populations like the elderly or those with comorbidities within the given abstracts.Key Recommendations
Utilize hemogram parameters, including MPV and MPV/PLT ratio, to assess the risk of postoperative vomiting in pediatric patients undergoing deep sedation (Evidence: Moderate 1).
Consider intravenous anaesthesia techniques with agents like ketamine and propofol over inhalation anaesthesia with sevoflurane to reduce the incidence of postoperative vomiting in children at risk 2 (Evidence: Moderate).
Implement regional analgesia methods, such as ilio-inguinal block, to decrease the likelihood of postoperative vomiting in susceptible pediatric patients 2 (Evidence: Moderate).References
1 Canpolat DG, Dogruel F, Gönen ZB, Yılmaz C, Zararsız G, Alkan A. The role of platelet count, mean platelet volume, and the mean platelet volume/platelet count ratio in predicting postoperative vomiting in children after deep sedation. Saudi medical journal 2016. link
2 Sarti A, Busoni P, Dell'Oste C, Bussolin L. Incidence of vomiting in susceptible children under regional analgesia with two different anaesthetic techniques. Paediatric anaesthesia 2004. link