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Anesthesia | Preventing Post-op Nausea after Hysterectomy

From the Pre-Op Hysterectomy Articles List

Anesthesia after HysterectomyIs there anything that can be done to prevent me from being sick or nauseated from the anesthesia that will be used for my hysterectomy?

Nausea following a hysterectomy is generally attributed to at least five different triggers: pain medications, anesthetics, anxiety, adverse drug reactions, and motion. There are various ways of handling a patient with a known history of PONV (postoperative nausea/vomiting), and there are quite a number of antiemetic medications that can be given ahead of time to help prevent nausea.

For one thing, having adequate preoperative IV fluids has been shown to lower the incidence of nausea for patients undergoing general anesthesia. If you have experienced postoperative nausea in the past, be sure to let your surgeon know so he can make sure you have plenty of fluids.

There are also different anti-nausea medicines that can be given, including Zofran, Decadron, and Reglan, to try to prevent nausea when you wake up. Your anesthesiologist may choose to give you one drug or a combination of drugs to help minimize any postoperative nausea.

Using IV Tylenol as part of general anesthesia before surgery is known to lower the chances of postoperative nausea. Postoperatively, Toradol, a very strong anti-inflammatory pain medicine that lessens the need for Morphine, Dilaudid, or other narcotics after surgery, may be given when appropriate. The less narcotic medication you use, the better for resolving nausea.

If you have a history of motion sickness, your anesthesiologist may add a scopolomine patch. He may also avoid using Nitrous Oxide as it can contribute to nausea in patients who have experienced motion sickness.

If you have had nausea with anesthesia in the past, particularly if it was severe, happened multiple times and/or occurred in spite of anti-nausea medicines, your anesthesiologist may choose to use a combination of treatments. You could be given an increased dose of Zofran, a scopolomine patch, and no Nitrous Oxide will be used even if you have not had motion sickness in the past. In addition, at least one additional anti-nausea medication may be given to you in the recovery room before you wake up, usually compazine. Phenergan also works well in many patients, but it could make you quite sleepy.

If you have a known history of difficulty with nausea and surgery, there are a couple additional options. A drug called Emend can be given 3 hours or more before surgery. This single pill works very well in many patients who are known to get nausea, but it can be costly (up to $80 for a single pill), and many pharmacies don't keep it in stock, so you'll have to order it several days before surgery.

A second option is an anesthetic technique called Total IV Anesthesia (TIVA) that avoids the use of all anesthesia gases and Nitrous Oxide. TIVA is generally successful for patients who tend to get sick with general anesthesia.

Although anesthesia is a common cause of post-op nausea, there are other causes, including pain and narcotic pain medicines. If you have gotten sick from narcotic pain medications in the past, you may need to avoid these for your hysterectomy.

If you have had issues with post-op nausea in the past, you will want to sit down and discuss your history with your surgeon so you can come up with a plan that is right for you. If possible, you may also want to meet with the anesthesiologist prior to the day of your hysterectomy.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

04-14-2014 - 01:01 PM


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