A Factorial Trial of Six Interventions for the Prevention of
Postoperative Nausea and Vomiting

Lars I. Eriksson, MD, PhD

Introduction: Among critical events in the immediate postoperative period, ventilatory depression, airway obstruction, and aspiration of gastric contents are the three most common life-threatening anesthesia-related complications. They account for more than two thirds of all critical events after an anesthetic procedure, and in most of these events the consequence for the patient is a risk of hypoxic injury. Residual effects of anesthetics play essential roles as underlying mechanisms of postoperative ventilatory failure and hypoxia. Impaired respiratory control may be caused by depression of central ventilatory control, by depression of peripheral sensory organs, such as the carotid body chemoreceptors, or by impaired control of the pharynx and the upper airways due to muscular weakness and dyscoordination with risk for airway obstruction and aspiration. In this review, new findings concerning ventilation and residual effects of neuromuscular blocking drugs and volatile inhaled anesthetics will be put in perspective.

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