Tips For Preventing and Treating Nausea After Surgery

Dealing With a Common Surgery Complication

Nausea and Vomiting After Surgery
Nausea is Very Common After Surgery.

Postoperative nausea and vomiting (PONV) is an enormous problem for patients recovering after surgery.  Over half of all surgery patients experience nausea and vomiting, some immediately after surgery, and others once they get home and are recovering there. 

Feeling nauseated after surgery is uncomfortable and can dramatically slow the return to normal activities like eating and drinking. Vomiting is more serious, as it can be very painful after surgery and can put large amounts of stress on some surgical incisions, leading to major complications like dehiscence and evisceration, dehydration and more.

Regardless of how or why nausea and vomiting begins, quick action may help prevent more serious issues.  With quick treatment, nausea can often be prevented from turning into an episode of vomiting.

Why Is Nausea Common After Surgery?

While nausea and vomiting after surgery is a known risk of anesthesia, there are other factors that can play a role, such as dehydration, medications being given on an empty stomach, an aggressive return to a normal diet, and a lack of preventative nausea and vomiting medication.

For some patients, nausea and vomiting after surgery is something that they experience every time they have anesthesia.  For these patients in particular, preventing the problem is of great importance. This may mean medications being given prior to and even during surgery, so they are in full effect once the surgery is completed. 

10 Tips For Preventing Nausea and Vomiting After Surgery

Prevent Dehydration

One way to prevent PONV is to prevent dehydration.

  With the anesthesiologist’s blessing, many patients are able to drink clear liquids up until the hours immediately before surgery without complications.  Food and non-clear liquids are still not appropriate prior to surgery, but some clear fluid intake may help prevent nausea and vomiting.

Tell Your Care Team About Your Nausea

Reporting nausea as soon as it occurs is important.

  Your nurse should be made aware of the issue if you are in the hospital, your surgeon should be told if you are recovering at home.  Medications can be prescribed to help minimize the problem if your care team is aware of the issue.

Talk to Your Anesthesiologist

Another method requires a discussion with anesthesiology regarding previous episodes of nausea and vomiting after surgery.  If the problem is known, the anesthesia provider can choose anesthesia medications that are less likely to cause nausea and vomiting.

Prevention is Key

Medications can be given to prevent nausea before it happens.  Some surgeons routinely include anti-nausea medications in postoperative orders to minimize the problem. If you have experienced nausea and vomiting in the past, be sure to let your care team know so that preventative measures can be taken.

Control Your Pain

Don't skip your pain medication because you are feeling nauseated if you can help it. Pain control can help decrease the incidence of nausea and vomiting after surgery.

 The presence of pain can increase the likelihood of vomiting, but many patients avoid their pain medication because they feel nauseated.  When possible, treating pain effectively can also be a treatment for nausea.

Don’t Rush Your Diet

A slow return to normal foods is an ideal way to minimize nausea.  After surgery, the diet typically starts as nothing by mouth until the patient passes gas. Once the patient is able to pass gas, clear fluids in small amounts should be tried over the course of a few hours to insure that they won’t induce nausea or vomiting.  If clear fluids are tolerated, other liquids such as juice, tea, milk and coffee may be introduced.  If these are tolerated, a soft diet of foods such as applesauce or pudding is next, with a full diet being introduced only when the others were successfully tolerated. 

This process of advancing the diet is often done over the course of several days if the surgery was a major one.  A slow progression is key to success.

Temperature May Be Key

Some patients are very sensitive to the temperature of fluids.  They may tolerate room temperature fluids or warm fluids well, but cannot tolerate cold drinks.  The opposite may also be true.  

Ginger, Ginger, Ginger

Ginger ale that has been allowed to go flat has been found to be soothing to the stomach and can often be used as a treatment for nausea.  Beware, fully carbonated drinks can make the stomach feel bloated and can contribute to nausea. 

Ginger in general has been shown to help nausea, so ginger candy and other types of ginger foods can be of use, as long as they have real ginger as an ingredient, not ginger flavoring.

Combat Dehydration

If dehydration is a problem, drinks with electrolytes in them may help return the body to normal more quickly than other beverages.  There are many types of electrolyte replacement drinks, ranging from Gatorade to Pedialyte.

Sources:

Postoperative Nausea and Vomiting.  Annals of Palliative Medicine.  Accessed October, 2014.  http://www.amepc.org/apm/article/view/1035/1261

Putting a Stop To Postop Nausea and Vomiting.  American Nurse Today. Accessed October 2014. http://www.americannursetoday.com/putting-a-stop-to-postop-nausea-and-vomiting/

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