Pediatric PONV

 

Pediatric PONV Risk Factors:

  • Preop:

    • Age ≥3 yrs

    • Hx PONV/motion sickness

    • Family hx PONV

    • Post-pubertal female

  • Intraop:

    • Strabismus surgery

    • Adenotonsillectomy

    • Otoplasty

    • Surgery ≥30 mins

    • Anticholinesterases

  • Postop:

    • Long-acting opioids

 

Risk categories based on number of risk factors:

  • Low: 0

  • Medium: 1-2 

  • High: ≥3

Prophylactic Agents to Give Based on Risk:

  • Low: None or 5-HT3 antagonist or dexamethasone

  • Medium: 5-HT3 antagonist & dexamethasone  

  • High: 5-HT3 antagonist & dexamethasone & consider TIVA

 

Treatment of PONV in Pediatrics

  • Use anti-emetic from different class than prophylactic drug

  • Droperidol, promethazine, dimenhydrinate, metoclopramide

  • Consider acupuncture/acupressure (see non-pharmacological options)

 

 

Adapted from Anesth Analg. August 2020 - Volume 131 - Issue 2 - p 411-448

 All rights reserved 2017 © anesthesiaconsiderations.com

 Feedback & inquiries: