Despite great advances in modern medicine, postoperative nausea and vomiting (PONV) continue to be a significant problem without a definitive cure. This article describes a prospective study conducted with 143 plastic surgery patients at a single institution between 1998 and 2000 to identify preoperative risk factors for PONV that may be specific to plastic surgery patients. In addition, a prophylactic regimen was identified that demonstrated a decrease in the incidence of PONV from the published incidence of 22% to 3%. The regimen includes the use of multiple antiemetic agents including ondansetron (Zofran) promethazine (Phenergan), and metoclopramide (Reglan), with the addition of dexamethasone (Decadron) in selected cases.
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