Authors: Portnoy Y, et al.
Anesthesia & Analgesia. 2025;141(1):77–85.
This large retrospective study examined over 3,700 pediatric surgeries and found a low overall incidence of postoperative nausea and vomiting (PONV)—1.0% early and 3.8% delayed. However, only 32.5% of cases adhered to the Fourth Consensus Guidelines for PONV management. Factors like age ≥3 years and long-acting opioid use were associated with higher guideline adherence. Importantly, nonadherence doubled the risk of PONV at 24 hours post-op. The study highlights the need for standardized definitions and stronger implementation of evidence-based PONV protocols in pediatric anesthesia.
KEY POINTS
Question: What is the incidence of postoperative nausea and vomiting (PONV) in a diverse pediatric population, and how well do current practices adhere to the latest consensus guidelines?
Findings: PONV Incidence was low (1.0% for early PONV and only 3.8% for delayed PONV), with only 32.5% receiving guideline-adherent prophylaxis.
Meaning: The discrepancy between low incidence of PONV and low adherence to guidelines highlights the need for further research to understand and improve guideline implementation and its impact on patient outcomes.
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