Postoperatieve complicaties, exclusief respiratoire
Postoperatieve complicaties, exclusief respiratoire
Postoperatieve complicaties, exclusief respiratoire
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Identificatie<br />
Apfel et al.1999: SIMPLIFIED RISK FACTOR CHART<br />
Female sex 1<br />
‣ Non-smoking status 1<br />
‣ History of PONV / 1<br />
Motion Sickness<br />
‣ Post-operative use 1<br />
of opioids<br />
Sum of risk factors 0 till 4<br />
80<br />
70<br />
60<br />
50<br />
40<br />
30<br />
20<br />
10<br />
0<br />
79<br />
61<br />
39<br />
21<br />
10<br />
0 1 2 3 4<br />
PONV Flow diagram<br />
Patient factors<br />
Female sex<br />
History of PONV<br />
or motion sickness<br />
Non-smoker<br />
Postoperative opioid use<br />
Surgical factors<br />
Laparoscopy<br />
Laparotomy<br />
Plastic surgery<br />
Major breast surgery<br />
Craniotomy<br />
Otolaryngologic procedures<br />
Strabismus surgery<br />
Mild to moderate risk Moderate to high risk Very high risk<br />
20-40%<br />
40-80%<br />
>80%<br />
1-2 factors present<br />
3-4 factors present<br />
>4 factors present<br />
Any one of the following<br />
Droperidol<br />
Dexamethasone<br />
Scopolamine<br />
Serotonin antagonist<br />
Droperidol plus<br />
Serotonin antagonist<br />
Or<br />
Dexamethasone plus<br />
Serotonin antagonist<br />
Combination antiemetics<br />
Plus<br />
Total intravenous<br />
Anesthesia with propofol<br />
Gan TJ 2002 JAMA<br />
22
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