Archive February 2003 IV, No. 2

Outpatient Centers Get Aggressive with PONV Prophylaxis

While most use an aggressive strategy, many remain unsure of the best way to prevent PONV.

Many outpatient practitioners administer some type of antiemetic to surgical patients regardless of the PONV risk, according to the results of an Outpatient Surgery reader poll of 32 readers. Forty-one percent said all surgical patients should receive PONV prophylaxis and 12 percent were unsure. Even though studies indicate that such a universal approach is not cost-effective, many practitioners seem to feel otherwise. "Delay of discharge and patient dissatisfaction are more costly than drug costs," wrote one director of nursing at a center where even elderly patients undergoing cataract extraction receive a prophylactic 5-HT3 receptor antagonist. Noted another medical director of a multispecialty center where nearly all patients receive at least one prophylactic antiemetic drug: "Aggressive use of PONV prophylaxis at our center has helped keep PONV consistently below 5 percent."

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