Evidence-Based Antiemetic Decision Tool for Management of Postoperative Nausea and Vomiting in Patients at High Risk of QT Prolongation and Patients Receiving Neurotransmitter-Modulating Medications.

Anesthesia providers have a myriad of medication options when developing and implementing a plan for the management of postoperative nausea and vomiting (PONV). However, anesthetists must be aware of the potential side effects, complications, and interactions of those medications, especially when managing high-risk populations. Although guidelines exist for the management of PONV in the general population, an evidence-based antiemetic decision support tool has not been developed for patients at risk of prolonged QT interval or for patients who are routinely receiving neurotransmitter-modulating medications. Safe practice recommendations exist but are scattered throughout the literature. The goal of this project was to develop a tool for anesthetists that concentrates the evidence and provides practice guidelines in these 2 selected populations. The methods for developing this tool were to perform a thorough literature search to gather evidence-based guidelines, organize findings in a convenient easy-to-read format, and validate guidelines by consultation with an expert panel. The product is a quickly accessible clinical tool listing guidelines for 8 commonly used antiemetic agents to assist anesthetists in PONV management.