Nausea and Vomiting
Nausea and vomiting
Most people feel sick to their stomach (nausea) or vomit at some point in their lives. Nausea is an unpleasant feeling in the stomach that makes you think you may throw up. Some people say it feels like being sick, queasy, or having a stomachache. Nausea does not always lead to vomiting.
Vomiting is when your stomach contents come out through your mouth. Many people experience nausea before they vomit. But sometimes vomiting can happen without warning. Feeling sick and vomiting can happen for many reasons. Common causes include food poisoning, infections, motion sickness, medicines, and anesthesiaThe use of medications to temporarily block pain, sensations, and awareness during procedures and surgery. There are many different types of anesthesia that a CRNA can provide. .
What causes nausea and vomiting after surgery?
Nausea and vomiting after surgery can happen for a few different reasons. These include:
- Pain medications: Especially opioidDrugs that are typically used to control and manage pain. Examples include codeine, morphine, and fentanyl. (narcotic) medications.
- The surgery itself: Some types of surgery are more likely to lead to nausea and vomiting compared to others (see below).
- Your own body: Some people are simply at a higher risk for postoperativeAfter surgery nausea and vomiting (PONV).
- Anesthesia medications: Some of the medications used during anesthesia can increase your risk for PONV (see below).
Anesthesia and PONV
There are different types of anesthesia that work in different ways. General anesthesiaA state of unconsciousness that is caused by medications administered by an anesthesia professional. This form of anesthesia is often used for procedures that would be too painful or uncomfortable to perform while the patient is only sedated or awake. has the highest risk of PONV, especially if anesthetic gasesMedications that you breathe in during anesthesia. These gases make you unconscious (asleep) and unaware. They also make you forget what happens during surgery and can prevent you from moving while you are asleep. are used. This is because the medicines in these gases can trigger the “vomiting center” in your brain. This leads to feeling sick and vomiting. Specifically, nitrous oxide can build up in closed spaces such as your middle earThe part of the ear between the eardrum and inner ear. It moves sound vibrations and controls air pressure. and intestines. This can lead to a feeling of pressure in the abdomenSometimes called the “belly” or “core,” this is the part of the body below the chest and above the pelvis. when you wake up. Learn more about the different types of anesthesia.
SedationSometimes called conscious sedation or twilight anesthesia, this is the use of medications to help you feel relaxed and calm, and sometimes fall asleep during your medical procedure. and regional anesthesiaA type of anesthesia that blocks pain in a larger area of the body by numbing a group of nerves and involves techniques such as nerve blocks, epidurals, and spinals. can also lead to PONV. But the risk is much lower than with general anesthesia. Different types of regional anesthesia, such as spinalsSometimes called a “spinal block,” this is an injection of numbing medication into the spinal fluid that numbs the body from the waist down. and epiduralsAn injection of numbing medication into the epidural space that blocks pian signals from specific nerves. Epidurals can be given as a single injection, or with a catheter (tubing) that stays in place to continuously give medication. , also have a small risk of PONV as well.
Possible reasons why anesthesia may lead to nausea and vomiting include:
- A side effect of anesthesia and pain medications
- Pressure changes in the middle ear if nitrous oxide is used as part of your general anesthetic
- Triggering of the gag reflexSometimes called the pharyngeal reflex. This is an automatic response that happens at the back of the tongue and throat. This reflex helps stop you from choking and swallowing something harmful. It causes a "gagging" feeling.
- Pain
- Quick position changes
- Low blood oxygen level or low blood pressure
What increases my risk for nausea and vomiting after surgery?
The risk of nausea and vomiting can increase because of personal and surgery-related factors. Personal factors include:
- Sex: Women are more likely to feel sick and vomit after anesthesia than men.
- Smoking: People who don’t smoke are at higher risk for nausea and vomiting after anesthesia than smokers. This is because smoking can make the “vomiting center” of the brain less sensitive. Smoking is not recommended or safe for your overall health. Learn more about Smoking and Anesthesia.
- Family history: If people in your family have felt sick and vomited after anesthesia or had other reactions to anesthesia, your risk may be higher.
- Medical history: If you have felt sick or vomited after anesthesia before, or if you get motion sickness, your risk is higher.
- Age: People under 50 years old are at higher risk.
Surgery-related factors include:
- Type of anesthesia: Nausea and vomiting happen most often with general anesthesia. But they can also happen with sedation and regional anesthesia.
- Length of surgery: The longer the surgery, the higher the risk of nausea and vomiting after surgery.
- Type of surgery: Gall bladderA small organ below the liver that stores and releases bile, which is needed to break down fats in the digestive system. , uterineCommonly called the “womb,” this is a muscular organ in the female reproductive system that is responsible for menstruation (the period), growth and development of a pregnancy, and the delivery a baby. , and laparoscopicSometimes called "keyhole" procedures. These are minimally invasive surgeries where a surgeon can look inside the abdomen (belly) and pelvis through small incisions. surgeries have a higher risk of nausea and vomiting after surgery.
Can I prevent nausea and vomiting after surgery?
There is no way to completely prevent nausea and vomiting after anesthesia and surgery. But one of the best things you can do is tell your anesthesia professional, such as a Certified Registered Nurse Anesthetist (CRNA)Sometimes called a CRNA, nurse anesthesiologist, or nurse anesthetist, these are advanced practice registered nurses (APRN) who specialize in administering anesthesia for surgical, diagnostic, and therapeutic procedures. , about any of the personal risk factors listed above. If you get motion sickness or have felt sick and vomited after anesthesia before, make sure to share this information with your anesthesia professional. Your anesthesia professional can make changes to your anesthesia plan and give you anti-nausea medications (antiemeticsMedicines that help relieve nausea and vomiting. ) to help reduce the risk of nausea and vomiting after you wake up.
If you have had nausea or vomiting after surgery in the past, your anesthesia provider may also give you a medicine called a scopolamine patch. This patch is worn behind your ear. You can wear it for up to 72 hours to help prevent and manage nausea and vomiting. These patches can cause dizziness, drowsiness, blurred vision, and/or dry mouth, so they may not be the best choice for everyone.
Treatment
If someone feels sick or vomits after anesthesia and surgery, it usually starts within a few minutes to hours after waking up. Luckily, these symptoms typically improve quickly. If you start to feel like you need to vomit while waking up from anesthesia, tell your recovery nurseA licensed healthcare professional who practices nursing care. All RNs complete special education and training and are licensed to provide nursing care in their state. . Your nurse has medications to help the nausea and vomiting go away. Once you are awake, taking small sips of water and slowly adding fluids and food back into your diet can help with these symptoms.
While PONV is usually easy to treat and manage, sometimes these symptoms may last for a few days. If you are at home, you can manage these symptoms by:
- Taking prescribed anti-nausea medications if ordered
- Slowly add fluids and food back into your diet. Learn more about Eating and Drinking after Anesthesia.
- Control pain
- Rest and avoid quick changes in your body position
- Drink plenty of fluids
Rarely, some people may have nausea and vomiting that don’t go away. Vomiting that lasts over 24 hours can slow down your recovery. It can also lead to serious problems such as aspirationThe inhalation of foreign materials, including food, water, stomach contents, and saliva, into the airway and lungs instead of being swallowed down the esophagus. Aspiration can lead to pneumonia, lung damage, and can even be a medical emergency. , pneumoniaAn infection of one or both lungs. This infection can lead to inflammation and difficulty breathing. , dehydrationWhen the body has less water than it needs to work properly., esophageal ruptureA serious medical emergency that happens when the esophagus tears or opens. This can happen because of severe vomiting., electrolyteImportant minerals in your body that help it work properly. These can be provided before, during, and after your procedure to help keep you healthy. imbalances, and wound dehiscenceSeparation of surgical wound edges. . If you cannot keep food and fluids down and have been vomiting for over 24 hours, tell your healthcare team right away. Learn more about When to Contact Your Healthcare Team.
Frequently Asked Questions
Common questions about nausea and vomiting after surgery.
How common are nausea and vomiting after surgery?
About 30-40% of patients experience PONV.
How long does nausea and vomiting last after surgery?
Nausea and vomiting usually start within a few minutes to hours after waking up. Usually, these symptoms go away quickly with medication. Sometimes it may take a few days for these symptoms to go away.
Can I prevent nausea and vomiting after surgery?
There is no way to completely prevent nausea and vomiting after anesthesia and surgery. However, your anesthesia professional can give you medications to help lower the chance of PONV. If you have any risk factors for PONV, make sure you discuss these with your anesthesia professional before your surgery or medical procedure.
How can I manage nausea and vomiting at home?
You can manage nausea and vomiting at home by:
- Taking prescribed anti-nausea medications if ordered
- Slowly add food back at home
- Take your prescribed pain medication as directed
- Rest and avoid quick changes in your body position
- Drink plenty of fluids when feeling better
When should I call my healthcare team?
Call if you have vomiting that doesn’t get better or if you have been vomiting for over 24 hours. Also call if your nausea is so bad that you can’t eat or drink anything.
Disclaimer: The information on this page is for general educational and informational purposes only and does not constitute medical advice or a recommendation for any specific anesthesia technique, drug, or treatment. Users should consult a qualified medical professional before making any decisions regarding anesthesia care. For complete terms, see our Terms of Use.
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