Expert: Ronald Levy, M.D. - 10/5/2007

Question
QUESTION: Hello, i would like to know the prevention of PONV and its biochemical causes. Thank you in advance.

ANSWER: There is a vomitting center in the medulla that is likely involved in PONV. A web site that explains this is:
http://www.nauseaandvomiting.co.uk/NAVRES001-3-PONV.htm

The various drugs that treat PONV are generally serotonin antagonists which not only treat the PONV but also have fewer side effects the earlier treatments.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: I would like to know the advantages of using general anesthesia over regional anesthesia or vice versa? How would using general and/or regional benefit or cause harm to the body?

Answer
This question has so many answers that I wouldn't know where to start.

GA Advantages:
1) Pt is asleep.
2) Pt doesn't move or fidget
3) Pt is not anxious hearing sounds in the OR
4) Pt is relaxed
5) Protected airway

RA Advantages
1) Pt is awake so can tell you of a problem
2) Good post op pain relief
3) Low risk of aspiration or lost airway
4) Less invasive

As for benefit or harm, neither has any great risk of harm (or benefit for that matter) although there is some evidence that RA is better for peripheral vascualr surgery.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston