JUSTIFY Flashcards
1
Q
Justify your use of antiemetics
A
PONV is common and unwanted side effect of anaesthesia.
Can increase PACU stay, unplanned admission or potenitally morbidity eg - eye surgery, gastric surgery
I conduct a risk assessment using Apfels risk score
(female, PONV prev, post op opioids, non smoker)
0-1 20%, 2 40% 360% 4 80%
Antiemetics are part of overall PONV strategy eg TIVA, regional, multimodal
0-1 I give a single antiemetic - Ondansetron as NNT6 NNH 20, common side effects are headache and constipation
Score 2 - 1 antiemetic +/- TIVA
Score 3 - 2 antiemetics + TIVA
Second drug is Dexamethasone 0.1mg/kg
