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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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