Management of Postoperative Nausea and Vomiting after Neurosurgery

The incidence of postoperative nausea and vomiting (PONV) after craniotomies has been reported from 55% to 70%. The reasons for the high incidence of PONV may relate to surgery being performed in close proximity to emetic centers of the brainstem or on the structures integral to maintenance of equilibrium. Prophylaxis and treatment of PONV are fundamental parts of the perioperative anesthesia management in neurosurgery and require several steps: recognition of patients at risk for PONV; avoidance, when possible, of factors precipitating PONV; prophylaxis; and treatment which should be done selectively.