Pathophysiology and Risk Stratification of Postoperative Nausea and Vomiting (PONV)
Postoperative Nausea and Vomiting (PONV) is one of the most common complications following general anesthesia, affecting approximately 30% of the general surgical population and up to 80% of high-risk patients.
The Emetic Reflex Arc
The sensation of nausea is controlled by the "vomiting center" in the medulla oblongata. It receives inputs from:
The Chemoreceptor Trigger Zone (CTZ): Located in the area postrema, it senses blood-borne toxins and anesthetic agents.
The Vestibular System: Triggered by motion and middle ear pressure changes.
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