POST OP NAUSEA -which drug do you like?

I work on a med-surg floor and we mostly do gynecological surgeries, though we have others too. It seems most people coming back have nausea/vomiting within a couple hours. Most of our post op standing orders call for Phenergren IV, PO, or PR , Onadestron or Reglan. Reglan is useless if they are not eating. Zofran has little effect it seems and Phenergren zonks them out so bad I HATE giving it. They are already drowsy, on PCA's of some sort and had spinals.

What do you all do? What can we suggest to the MD's? Vistaril is seldom if ever used. One older RN told me once of some drug they gave that worked wonders and was very inexpensive, but I can't think of it. (maybe droperidol? or Tigan? ) She did not know why they don't give it anymore, but said they still have it in the pharmacy. I have never used either of them.

When I had surgery the anesthesists always gave me something and I never had post op nausea.

So, whats your opinion? Last edit by Fairlythere on Jul 30, '07
Quote from FairlythereWhen I had surgery the anesthesists always gave me something and I never had post op nausea. So, whats your opinion?

For many patients post-op nausea and vomiting is worse than the pain. I agree with you--phenergan knocks people out, Zofran doesn't really work that great, neither does Reglan... Scopalamine pre-op works very well for PONV but is not used that widely. In my opinion, until we have a "wonder drug" that actually eliminates nausea we will have to use other techniques for controlling it. The first one being to hold off on eating until several hours after surgery. Some patients are so insitant on eating right after surgery and the stuff they want is horrible. Eggs? Hamburgers? Milkshakes? Yikes! That's just asking for trouble. I always give people ice water and crackers and thats it unless they feel like juice or 7-up, coffee etc. There is no need to rush to advance the diet until anesthesia has worn off more.

I find that Anzamet is quite effective.

I've always been premedicated with Zofran and Reglan, and it's never worked for me.....only because it wasn't until the last surgery that we figured out it was the morphine causing it. Apparently I'm really sensitive to that. Once I had morphine on board, nothing worked except for droperidol. It's not a popular drug, though, because it sedates even more than Phenergan does.

We have had some surgeons use meclizine or antivert with some success, I like droperidal but it seems to not be used that much anymore. Anzemet works too.:spin:

12.5 of dilaudid not only soothes N/V, it also stops that post op "shiver" and keeps your post op patient comfortable but arousable. Ask your anesthetist.

Our new orthopedic orders call for Reglan every 6 hours, and Zofran every 8 hours for about the first 48 hours post op. I think it would probably work except that those same orders have us giving PO meds as soon as they get on the floor, and a lot of times these patients don't have bowel tones. I do believe that we see less post op nausea this way then we did before though.

I have n/v after every surgery no matter what. I tell them ahead of time, I do not know what they give me but I still get sick. When I had my gall bladder surgery I had to stay another day because of n/v finally they gave me phenergan IM. It hurt like the dickens but it worked for the n/v. Problem is it still hurt a few days later where I got the IM injection.

Quote from montanaladiWe have had some surgeons use meclizine or antivert with some success, I like droperidal but it seems to not be used that much anymore. Anzemet works too.:spin:

Quote from Haunted12.5 of dilaudid not only soothes N/V, it also stops that post op "shiver" and keeps your post op patient comfortable but arousable. Ask your anesthetist.

Have suffered PONV previous 6 suguries but on my 7th was given zofran 8mg IV on induction what a difference it made no nausea or vomiting up and about within a couple of hours and personaly speaking i required much less post op analgesia as well.

Quote from Haunted12.5 of dilaudid not only soothes N/V, it also stops that post op "shiver" and keeps your post op patient comfortable but arousable. Ask your anesthetist.