Supplemental intraoperative crystalloids for pediatric postoperative nausea and vomiting
A systematic review and meta-analysis
Pediatric Anesthesia
Submitted January 2023 by Dr Justin Skowno
PONV is an unpleasant complication of anaesthesia and surgery that we should all be doing our best to minimise. This meta-analysis cobbles together the relatively meagre number of studies looking at the role of IV fluids in the reduction of PONV in paediatrics and gives a clear “YES” as the answer. Their paper follows a good methodological approach and is only held back by the studies available to them. They discuss things well, particularly the fact that the studies didn’t use any anti-emetics, used mostly sevoflurane and nitrous oxide (emetogenic anaesthesia) and no TIVA was used. Thus, they may be fairly far from current state of the art.
However, the simple and safe use of a generous amount of IV fluid helps with PONV and post operative thirst and should be something we consider for all procedures. I’ve sometimes not wanted to “unnecessarily” give IV fluids for some shorter procedures to save on money and plastics, but I’ll reconsider this, whilst at the same time giving TIVA and anti-emetics as a routine.
