الفهرس 
NAUSEA AND VOMITINGOnly 14 pages are availabe for public view
 |  | from | 121 |  |  |
| | | from | 121 | | |
Abstract
P
ostoperative Nausea and vomiting are among the most distressing post-operative complications. Routine prophylaxis is becoming a growing demand and the choice of antiemetics is very broad. Prompt dealing with the multiple risk factors involved in PONV is also an important aspect of the problem.
Physiology of Nausea and vomiting
Key structures and pathways identified are:
• The chemoreceptor trigger zone in the area postrema which responds to circulating emetogenic neurotransmitters , hormones , toxins , and drugs .
• The vomiting center in the reticular formation which coordinates the visceral and somatic components of the emetic reflex.
Risk factors for PONV
I. Patient-related factors
A-Pre-existing patient factors
Female gender, history of PONV, motion sickness or migraine.
B-Preoperative factors
Prolonged fasting, full stomach, anxiety and drugs like opioids.
II. Anesthesia -Related factors:
Opioids, nitrous oxide, some intravenous agents like ketamine and volatile anesthetic agents.
III. Surgery-Related Factors
Type and duration of surgery.
IV. Postoperative factors
Dehydration, hypotension, hypoxia, early ambulation, early oral intake and Pain
Prevention & treatment of postoperative nausea & vomiting
Drugs used for the symptomatic relief of nausea and vomiting include:
• Dopamine receptor antagonists.
• Muscarinic receptor antagonists
• Histamine H1 receptor antagonists
• 5-HT3 receptor antagonists
• Sedatives and hypnotics
• Phenothiazines
• Corticosteroids
• Neurokinin1 (NK1) receptor antagonists.
The study included 120 female patients were included in this study, their ages vary from 20 to 40 years old, ASA physical status І & ІІ, scheduled for day case diagnostic laparoscopic procedure. The patients were allocated randomly into three groups according to the antiemetic drug that was given. Each group consisted of 40 patients.