Prevention of  post-operative nausea

Until recently there was no good way to prevent vomiting. One could only try to treat it after it started.


Emend is a new drug that is taken the night before surgery and that can give up to 48 hours of nausea prevention. In my experience and after a recent trial we conducted at the surgery center where I perform my surgeries, Emend really does decrease the incidence of post-operative nausea.
Eating a light meal the night before surgery also makes sense in that your stomach’s being empty may reduce other stimuli that can excite the nausea center of the brain.
Avoiding alcohol and other drugs the night before surgery is a no-brainer!


Like all other actions of steroids (Dexamethasone 4mg- 10 mg), the exact mechanism of how steroids helps in plastic surgery healing is not known. We do know that steroids will “calm down” all systems and that injections of steroids during surgery will decrease the incidence of PONV.

Scopolamine (Scope patch)

Commonly used to prevent motion sickness leading to nausea, these little patches are placed behind the ear and the drug is absorbed through the skin. They can help!


There are a number of antacids that can be given during a surgery (such as Zantac), and these will decrease nausea after an operation.

Serotonin antagonists

Drugs of this class, such as Zofran, can significantly reduce both the risk and duration PONV.
Intravenous hydration
If you are dehydrated, you will have more nausea.Treatment of  post-operative nauseaAll of the above modalities used to prevent nausea in plastic surgery patients can also be used to treat it when it does occur, except for steroids, which do not work as a treatment!


I have found this technique to be very helpful. Application of firm pressure between the two central wrist tendons and one inch below the hand can significantly improve nausea.

Phenergan suppositories

I use this  anti-histamine as a last resort in cases of continued vomiting (where the patient cannot even keep a pill down). It can cause some respiratory depression, which in combination with other medications cosmetic patients take after plastic surgery can lead to problems.

What is the best thing to do? Ask your cosmetic plastic surgeon to use a combination of all of the above modalities for the best results. Maybe they know a trick of their own to help you keep things down.

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