Postoperative nausea and vomiting (PONV) is commonly associated with opioid analgesia.

Question: What general measures can you take to avoid postoperative nausea and vomiting?

Answer: You can:

• Keep starvation times short (but safe)
• Avoid inflating the stomach whilst ventilating with a facemask at the start of surgery
• If full stomach, empty the stomach with a naso-gastric tube
• Ensure child is well-hydrated - give IV fluids intraoperatively
• Maximize opioid sparing analgesia (local anaesthetics, paracetamol, NSAIDs)
• Minimize opioid use
• Nitrous oxide has minimal effect in inducing nausea in children

See also The Association of Paediatric Anaesthetists of Great Britain & Ireland Guidelines on the Prevention of Post‐operative Vomiting in Children which is available as a download in the Resources section.