Section 1: Feeling sick Section 1: Feeling sick This leaflet explains the causes of sickness following anaesthesia and surgery, what can be done to prevent it occurring, and treatments available if it does happen to you. Some words explained Nausea. This is an unpleasant sensation,
usually in the stomach, also described as
operation and anaesthetic you are having.
‘feeling queasy’ or ‘feeling sick’. It is often These are explained here. felt with the urge to vomit. Why do some people feel sick after Vomiting. This means being sick. It operations?
know affect how likely you are to feel sick
PONV. These letters are used to mean
post-operative nausea and vomiting. ‘Post-
The operation you are having
operative’ means that it happens after the operation.
Some operations cause more sickness than others, for example:
Anti-emetic drugs. These are medicines 4 operations in the abdomen or genital
that help to prevent or treat nausea and
General anaesthesia. This is a state of
you feel nothing and may be described as
Your anaesthetist will be able to tell you
Regional anaesthesia. This involves
if your operation is likely to cause post-
Drugs that are used
‘Anaesthesia Explained’, which is on the
(www.rcoa.ac.uk). Will I feel sick after my operation? Who you are
Not everyone feels sick after an operation
third of people (1 in 3) will experience a
1 Risks associated with your anaesthetic v Information for Patients: The Royal College of Anaesthetists Section 1: Feeling sick
4 those who suffer from ‘travel sickness’
particularly if you are retching or vomiting,
and it can delay when you start eating and drinking after your operation. This may
4 Being without food or drink before and
Rarely, if vomiting is severe and lasts a long
time, it can result in other more serious
problems, such as damage to your operation
site, tears to your oesophagus (gullet), or
Can anything be done to prevent me from feeling sick after my operation?
experiencing sickness when they visit you before your operation. I felt sick after my last operation. Will I feel sick after this operation?
anaesthetist can change your anaesthetic in order to reduce your chance of
reduce the likelihood of a recurrence.
operation performed under a regional anaesthetic rather than general
But if you have had sickness after surgery
‘anti-sickness’ medicines, called anti-
previously, you are more likely to have it
emetics, as part of your anaesthetic.1–5
again than if you have had an anaesthetic
4 Some anaesthetic drugs are less likely
to cause sickness than others. Your anaesthetist may decide that you are
How long does the feeling of sickness last?
short-lived or stops following treatment.
Uncommonly, it can be prolonged and last
Can feeling sick after an operation
called a ‘drip’). This may be given for
Feeling sick or vomiting after an operation is
2 Risks associated with your anaesthetic v Information for Patients: The Royal College of Anaesthetists Section 1: Feeling sick
4 Ondansetron (Zofran) or granisetron
have experienced it following a previous
(Kytril) or tropisetron (Navoban).
operation, it is important that you inform
4 Dexamethasone. Although a steroid Is there any treatment available if I feel sick after my operation?
nausea and vomiting does not seem to be associated with the side effects seen
Yes. If you feel sick after your operation,
4 Prochlorperazine (Stemetil).
4 Scopolamine (Scopoderm). Can
It is much easier to relieve the feeling of
sickness if it is dealt with before it gets too
bad. So, you should ask for help as soon
Can I do anything to avoid feeling What drugs may I be given and do they have side effects?
Anti-emetic drugs can be given as a tablet
4 avoid sitting up or getting out of bed
or as an injection. Injections can be given
intra-venously into your cannula or into your leg or buttock muscle. Intra-venous
injections work more quickly and reliably
after your operation. Start with small sips of water and slowly build up to
and avoid the need for another needle.
several different types. A combination of
anti-emetic drugs may be given, as this is
more effective than one drug given on its
Where can I get further information?
If you want to ask any further questions
about the type of anaesthetic planned for
4 Cyclizine (Valoid). May cause
your operation please contact your local
3 Risks associated with your anaesthetic v Information for Patients: The Royal College of Anaesthetists Section 1: Feeling sick References Dr Ian Selby, FRCA 1 Apfel CC et al. IMPACT Investigators. A factorial Consultant Anaesthetist
trial of six interventions for the prevention of
Hull Royal Infirmary
postoperative nausea and vomiting. N Engl J Med 2004;350:2441–2451. 2 Gan TJ. Risk factors for postoperative nausea and
vomiting. Anesth Analg 2006;102:1884–1898. Dr Tim Smith, MD FRCA 3 Harmer M. Pharmacological intervention in post- Consultant Anaesthetist
operative nausea and vomiting: scientific evidence
Alexandra Hospital, Redditch
and expert opinion for anti-emetic therapy for
Final FRCA examiner
prophylaxis. In: Strunin L, Rowbotham DJ, Miles A (Eds). The effective management of post-operative nausea and vomiting, 2nd edition. Aesculapius Medical Press, London 2003; pp 53–70. 4 Gan TJ et al. Consensus guidelines for managing
postoperative nausea and vomiting. Anesth Analg 2003;97:62–71. 5 Gan TJ et al. Society for Ambulatory Anesthesia
guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2007;105:1615– 1628. 6 Apfel CC et al. Acustimulation of P6: an antiemetic
alternative with no risk of drug-induced side-efects. Br J Anaesth 2009;102:585-586. The Royal College of Anaesthetists
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HERPES: GENITAL, VENERAL WARTS Herpes Simplex Type II(Genital Herpes) Genital Herpes Virus in the Nerve ganglia; Herpes I Virus; Blisters in 1-2 days, becoming open genital ulcers. Ulcers last 2 weeks or longer. From poor immune response, stress, sickness, menstruation, cold or fatigue. Herpes II virus in a pregnant woman may develop into fatal encephalitis requiring Caesarian Section; The sa