Recognition patient high risk Key to success Pharmacological 1. Ondansetron - at risk (0.15mg/kg) up to 4mg 2. Dex Very high risk Ondansetron and Dex (0.15mg/kg) 3. Opioid sparing technique if possible 4. Short acting Opioid where possible PRN 5. TIVA in extremely high risk (c/i in <3yo)

6. Paediatric PONV Flashcards by Sean Hartigan

Risk factors (12)

Patient

Age likelihood increase >3
& increase into adolescence

Prev Hx PONV

FH PONV

Hx motion travel sickness

F>M

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Surgical

Procedure

High risk

Ophthalmic 50-90% eg strabismus

ENT tonsillectomy / middle ear

Gynae

laparoscopic

Duration >30m

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Anaesthesia Related

Opioid use
Long>short
Postop > Intraop

Technique
Volatiles
anticholinesterases (

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Prevention

Recognition patient high risk
Key to success

Pharmacological

Ondansetron - at risk (0.15mg/kg) up to 4mg
Dex Very high risk Ondansetron and Dex (0.15mg/kg)
Opioid sparing technique if possible
Short acting Opioid where possible PRN
TIVA in extremely high risk (c/i in <3yo)

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Prevention - non pharmacological

Intraop IV fluid
Regional techniques
P6 acupuncture point
equally effective as drugs in prevention

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6. Paediatric PONV Flashcards

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