“Vomitting”
Every time over the past 25 years that I have had general anesthetic, I have had vomitting, including dry heaves afterwards. They have given me a variety of meds, but they don't work. I am waiting for abdominal surgery and very concerned that the vomitting will cause more harm (cause another hernia). What can be done?
Female | 66 years old
7 Answers
Anesthesiologist
You can request your anesthesiologist for a TIVA (propofol infusion) anesthetic as this would give you the best chances for living post op nausea and vomitting...additionally an intrathecal narcotic with spinal would also minimize your need for narcotics in the post operative period which can contribute to post op nausea and vomitting.
There are a variety of ways to minimize (but unfortunately not eliminate) the risk of nausea and vomiting as a consequence of general anesthesia. One way is to use a combined regional and general technique. One might have an epidural catheter placed before surgery. The epidural will provide analgesia and muscle relaxation for the procedure. The anesthesiologist can then use a propofol infusion for unconsciousness. That may be helpful.
Some patients, like yourself, are very prone to PONV, ie postop nausea and vomiting. In cases like that usually, combination therapy is used. It’s at least 3 anti-nausea meds, such as decadron, Zofran, and Reglan, that could be used. Also, perioperative use of a scopolamine patch could be effective. Some studies showed the effectiveness of wrist acupressure. And last but not least is the newest class of medications, so-called NK1 inhibitors, such as Aprepitant showed high effectiveness in late PONV, after ambulatory surgeries, when Pt was discharged home and still is nauseated 48 hours postop.
Vomiting, or emesis, is common after general anesthesia, especially in women who are undergoing outpatient surgery. The best anesthesia can do is to administer multiple antiemetic drugs, place a scopolamine patch behind your ear, and empty your stomach with an OG tube prior to waking you up from surgery.
Perhaps avoid anesthesia gases by administration of PROPOFOL drip. Also, infiltration of local anesthesia to minimize post-op narcotic requirements.
Vomiting after surgery. People who have this problem are at high risk. No guarantee it will not happen again. Some things can be done to mitigate vomiting. Typically Zofran and decadron are given during surgery. A scopolamine patch can be used before surgery. Also, Phenergan suppositories can be used.
If you have received the typical trifecta: Zofran, Decadron, and a scopolamine ear patch pre and intraoperatively but still have suffered postoperative nausea and vomiting, consider a "Relief band". People who have undergone chemotherapy and suffered significant nausea and vomiting have used this product and have enjoyed great success. Go to reliefband.com for product information and to purchase one if so desired. I do not know the cost but it surely would be worthwhile, especially contemplating abdominal surgery!
