Vomiting after surgery can cause complications like dehydration if it is severe. Between 20 and 80% of patients can expect to experience post-operative nausea and vomiting (PONV), depending on their medical history, the procedure, and other factors. Despite the best efforts of the medical profession, addressing this common side effect has been challenging. Patients should be aware that while it is normal to feel somewhat nauseous and perhaps vomit after surgery, repeat episodes should be reported to a doctor, as should severe pain or blood in the vomit.
Patients commonly feel nauseous while recovering from surgery because of the medications used in the operating room. Anesthesiologists use a variety of medications and typically try to limit the risk of nausea, but cannot prevent it entirely. Some drugs may be given to suppress nausea, especially if a procedure is known to cause distress. Women tend to experience vomiting after surgery more than men, as do people who have certain types of surgeries, like gynecological surgery.
Concerns with vomiting after surgery can include dehydration due to fluid loss, strain in the abdominal muscles, and tears in the esophagus. There is also a risk in patients in the early stages of recovery of aspiration, where vomit may enters the lungs. Typically patients need to spend some time in post-operative recovery for monitoring before they are allowed to go home, which allows care providers to catch cases of aspiration in a clinical environment so they can treat them quickly. Patients who accidentally inhale vomit are at risk of inflammation and pneumonia.
If a patient vomits in the recovery room, this may be noted in the chart and discussed with the doctor. In cases of extreme vomiting after surgery, the care provider may decide to offer the patient some medication to reduce the nausea while still controlling pain and discomfort. Patients may be allowed small sips of water for comfort, while receiving intravenous fluids to stay hydrated. As they feel stronger they can try juices and broths before graduating to bland solids.
Once patients go home, vomiting after surgery may occur in the first day or two. Patients should call their surgeons if they experience multiple episodes, feel extremely unwell, or notice other side effects. It’s possible they are still reacting to the surgery, or are sensitive to medications like pain management drugs or antibiotics. Cases of severe vomiting may require another trip to the hospital for an examination, while a more mild issue might be treatable with a medication change or dietary adjustments.