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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
having an operation, but it depends on what operation you are having, what anaesthetic and This is an unpleasant sensation, usually other drugs you receive, and on who you are felt in the stomach area, which can also be described as ‘feeling queasy’ or ‘feeling sick’. It is often felt with the urge to vomit.
Why do some people feel sick after
Vomiting This means being sick. It is the act of
operations?
forcefully emptying the stomach, or ‘throwing up’.
There are a number of factors that we know PONV These letters are used to mean post-
affect how likely you are to feel sick after an operative nausea and vomiting. ‘Post-operative’ means that it happens after the operation.
The operation you are having
Anti-emetic drugs These are medicines that
Some operations cause more sickness than help to prevent or treat nausea and vomiting.
General anaesthesia This is a state of
 operations in the abdomen or genital area you feel nothing and may be described as  ear, nose or throat operations (e.g. removal Regional anaesthesia This involves an injection
of local anaesthetic which makes part of your body numb. You stay conscious, but free from pain in that part of your body.
Your anaesthetist will be able to tell you if your operation is likely to cause post-operative You can find out more about general and regional anaesthesia in the booklet ‘Anaesthesia Explained’, which is on the Royal College of Anaesthetists’ Drugs that are used
Some drugs are known to cause sickness including: Will I feel sick after my operation?
Not everyone feels sick after an operation or anaesthetic, although it is a very common  pain relief drugs (especially the morphine- problem. Overall, about one third of people like pain-relieving medicines, including (1 in 3) will experience a feeling of sickness after 1 Risks associated with your anaesthetic
Information for patients: The Royal College of Anaesthetists Feeling sick
Who you are
I felt sick after my last operation.
Some people are more likely to suffer from post- Will I feel sick after this operation?
 Your operation may be different and less  Your anaesthetic can be tailored to reduce those who suffer from ‘travel sickness’  You may now be less likely to suffer (for example, the possibility of experiencing Other reasons
sickness after surgery lessens as you grow older).2  Being without food or drink before the But if you have had sickness after surgery afterwards. It is essential to avoid eating for six previously, you are more likely to have it again hours and drinking water for two hours before than if you have had an anaesthetic previously a planned operation. The reason for this is that if there is any food or liquid in your stomach during your anaesthetic, it could come up into How long does the feeling of sickness
the back of your throat and then go into your lungs. This would cause choking or serious Usually the sensation of sickness lasts an damage to your lungs. You should stop eating hour or two, or stops following treatment. and drinking for the amount of time advised, Uncommonly, it can be prolonged and last for  Being without food after the operation. This also contributes to feeling sick. The Can feeling sick after an operation
varies depending on your operation – some general guidance is given later in this Feeling sick or vomiting after an operation is article. Otherwise your nurses, surgeon and distressing and unpleasant. It can make the pain of your operation feel worse, particularly if you are vomiting or retching (trying to be sick, but  Being very anxious about what is happening nothing coming up). It can delay when you start can make you more likely to feel sick. You eating and drinking after your operation. This can tell your anaesthetist that you are feeling anxious. He/she will talk to you about your worries and you can ask for a medicine to 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  Travelling shortly after receiving a general oesophagus (gullet), or damage to your lungs.1 same day, you may find that you feel sick or vomit during the journey. You are more sensitive to travel sickness during this time.
2 Risks associated with your anaesthetic
Information for patients: The Royal College of Anaesthetists Feeling sick
Can anything be done to prevent me
be given anti-emetic (anti-sickness) drugs from feeling sick after my operation?
and intravenous fluids.3-5 Aromatherapy can also help : smelling rubbing alcohol (isopropyl Yes, although the risk of sickness can never totally be removed. Your anaesthetist will assess your risk of experiencing sickness when they visit you 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 as you feel sick.
There are various ways in which your anaesthetist can change your anaesthetic in order to reduce What drugs may I be given and do
they have side effects?
 You may be able to have your operation Anti-emetic drugs can be given as a tablet or as an injection. Injections can be given intra- rather than general anaesthetic, as this may venously into your cannula or into your leg or buttock muscle. Intravenous injections work  You may be given one or several ‘anti- more quickly and reliably and avoid the need for sickness’ medicines, called anti-emetics, as The same drugs are used to prevent and treat  Some anaesthetic drugs are less likely sickness after surgery. There are several different types. A combination of anti-emetic drugs may be given, as this is more effective than one drug  Acupuncture or acupressure can be used to prevent or treat sickness after surgery, but not All medicines have some side effects, although all hospitals are able to provide this treatment.
with anti-emetics these are generally minor and temporary, or rare. The following are commonly  You may receive intravenous fluids via a used anti-emetic drugs with their side effects. cannula (fluid goes into a thin plastic tube How likely you are to get the side effect is given placed in a vein – often called a ‘drip’). Fluid may be given for a variety of reasons, but studies have shown that in certain groups Cyclizine (Valoid) May cause drowsiness and
of patients, giving fluid can help to prevent  Ondansetron (Zofran) or granisetron
If you are worried about sickness, or have (Kytril) Can cause headaches (uncommon).
experienced it following a previous operation, it  Dexamethasone Although a steroid drug,
helps if your anaesthetist knows about it. the single dose given to prevent nausea and vomiting does not seem to be associated with Is there any treatment available if I
the side effects seen with long-term steroid use.
feel sick after my operation?
 Prochlorperazine (Stemetil) or
Yes. If you feel sick after your operation, the Metoclopramide (Maxolon) May cause
methods used to prevent you feeling sick can also be used to treat it. For example you could known as an extrapyramidal reaction (rare).
3 Risks associated with your anaesthetic
Information for patients: The Royal College of Anaesthetists Feeling sick
 Scopolamine (Scopoderm) Can be given
 good pain relief is important. Although as a stick-on patch 5-6 hours before your operation, to give it time to work. It can you feel sick, severe pain will too. You  taking slow deep breaths can help to reduce Can I do anything to avoid feeling
Where can I get further information?
If you want to ask any further questions about the type of anaesthetic planned for your  avoid sitting up or getting out of bed too operation please contact your local hospital or clinic before you come into hospital. Most  avoid eating and drinking too soon after hospitals provide an assessment clinic prior your operation, but do not delay too long. to your admission, staffed by experienced surgical nurses and anaesthetists. This is a good drinking and eating within 10 to 20 minutes moment to ask any questions that you have. as this improves your recovery. Start with small sips of water and slowly build up to bigger drinks and light meals. However, if you have had a more complicated operation your surgeon may not allow drinking or eating at first. Your nurses will give you advice about this 4 Risks associated with your anaesthetic
Information for patients: The Royal College of Anaesthetists Feeling sick
Dr Ian Selby, FRCA
1. Apfel CC et al. IMPACT Investigators. A factorial trial of six interventions for the prevention of 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. Carlisle J et al. Drugs for preventing post-operative nausea and vomiting. Cochrane Database Syst Rev 2006;3:CD004125.
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-effects.
Br J Anaesth 2009;102:585–586.
7. Hines et al. Aromatherapy for treatment of post- operative nausea and vomiting. Cochrane Database
Syst Rev 2012;4:CD007598.
The Royal College of Anaesthetists
Revised edition 2013
The material from this article may be copied for the purpose of producing information materials for patients.
Please quote the RCoA as the source of the information. If you wish to use part of the article in another
publication, suitable acknowledgement must be given and the RCoA logo must be removed. For more
information or enquiries about the use of this leaflet please contact:
The Royal College of Anaesthetists website: www.rcoa.ac.uk The Royal College of email: standards@rcoa.ac.uk This leaflet will be reviewed three years from the date of publication.
5 Risks associated with your anaesthetic
Information for patients: The Royal College of Anaesthetists

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