To summarize recent progress in the epidemiology, mechanisms, risk assessment, prevention, and treatment of postoperative nausea and vomiting (PONV) following thyroidectomy.
Approach:
Risk Assessment: Comprehensive risk assessments and individualized antiemetic strategies are essential for effectively reducing PONV.
Prophylactic Strategies: Evidence-based multimodal prophylactic strategies include total intravenous anesthesia (TIVA), opioid-sparing techniques, and intraoperative administration of serotonin receptor antagonists and corticosteroids, as supported by current consensus guidelines and randomized controlled trials.
Key Findings:
PONV occurs in approximately 30%-40% of patients undergoing general surgery, rising to nearly 80% in high-risk individuals.
In thyroidectomy patients, PONV incidence can reach 60%-84% without effective prophylactic strategies.
Risk factors for PONV include female sex, non-smoking status, history of motion sickness, and exposure to volatile anesthetics or opioids.
Interpretation:
A better understanding of PONV mechanisms may facilitate individualized risk stratification and optimize perioperative care.
Limitations:
Existing literature inadequately addresses thyroidectomy-specific risk factors such as vagal nerve stimulation and neck positioning.
Conclusion:
This review provides practical strategies to reduce PONV incidence in thyroidectomy patients.
