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This leaflet is adapted from the leaflet: Sickness after Anaesthetic, provided by the Royal College of Anaesthetists, the professional body responsible for the speciality throughout the UK, ensuring the quality of patient care through the maintenance of standards in anaesthesia, critical care and pain medicine.

Nausea is an unpleasant sensation, usually 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.

Vomiting means being sick. It is the act of forcefully emptying the stomach, or 'throwing up'.

PONV - these letters are used to mean post-operative nausea and vomiting. 'Post-operative' means that it happens after the operation.

Anti-emetic drugs are medicines that help to prevent or treat nausea and vomiting.

General anaesthesia is a state of controlled unconsciousness during which you feel nothing and may be described as 'anaesthetised'.

Regional anaesthesia 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.

Not everyone feels sick after an operation or anaesthetic, although it is a very common problem. Whether you will feel sick after an operation will depend on what operation you are having, what anaesthetic and other drugs you receive, and on who you are (see below).

There are a number of factors that we know affect how likely you are to feel sick after an operation.

The operation you are having

Some operations cause more sickness than others. Examples include:

  • Operations in the abdomen or genital area.
  • Gynaecological procedures.
  • Ear, nose or throat operations.
  • Surgery to correct a squint of the eye.
  • Very long operations.

Drugs that are used

Some drugs are known to cause sickness including:

  • Anaesthetic drugs, including some anaesthetic gases.
  • Pain relief drugs (especially the morphine-like pain-relieving medicines, including codeine).

Who you are

Some people are more likely to suffer from post-operative sickness:

  • Younger age.
  • Women.
  • Non-smokers.
  • Those who suffer from 'travel sickness'.
  • Anyone who has suffered from post-operative sickness before.

Travelling shortly after receiving a general anaesthetic. If you are going home the same day, you may find that you feel sick or vomit during the journey. You are more sensitive to travel sickness during this time.

If you have had sickness after surgery previously, you are more likely to have it again than if you have had an anaesthetic previously without any sickness.

However, your operation and the anaesthetic used may be different and less likely to cause sickness. Also, you may now be less likely to suffer (particularly because the risk of sickness after surgery gets less as you get older).

Usually the sensation of sickness lasts an hour or two, or stops quickly after you receive treatment for it. Much less often, feeling sick can be more prolonged and can last for more than a day.

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Feeling sick or vomiting after an operation is distressing. It can make the pain of your operation feel worse, particularly if you are vomiting or retching (trying to be sick, but nothing coming up). It can delay when you start eating and drinking after your operation. This may keep you in hospital longer.

Very 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 damage to your lungs.

There are a number of ways that your chance of suffering sickness can be reduced. These include:

  • You may be able to have your operation performed under a regional anaesthetic rather than general anaesthetic, as this may reduce the sickness that you feel.
  • You may be given one or several 'antisickness' medicines, called anti-emetics, as part of your anaesthetic.
  • Some anaesthetic drugs are less likely to cause sickness than others. Your anaesthetist may decide that you are suitable to receive them.
  • Acupuncture or acupressure can be used to prevent or treat sickness after surgery, but not all hospitals are able to provide this treatment.

Before any operation, always tell the anaesthetist or other member of the hospital team if you have previously felt sick or been sick after an operation, if you think you may be at increased risk because of any other reason, or if you're worried about feeling sick.

Yes. If you feel sick after your operation, the methods used to prevent you feeling sick can also be used to treat it. For example, you could be given anti-emetic (anti-sickness) drugs and intravenous fluids.

Aromatherapy can also help: smelling rubbing alcohol (isopropyl alcohol) may help you feel better. It is much easier to relieve the feeling of sickness if it is dealt with before it gets too bad.

Anti-emetic drugs can be given as a tablet or as an injection. Injections can be given intravenously into your cannula or into your leg or buttock muscle. Intravenous injections work more quickly and reliably and avoid the need for another needle.

The same drugs are used to prevent and treat 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 given on its own.

All medicines have some side effects, although with anti-emetics these are generally minor and temporary, or rare. The following are commonly used anti-emetic drugs.

After your surgery:

  • Avoid sitting up or getting out of bed too quickly.
  • Avoid eating and drinking too soon after your operation, but do not delay too long. Once you are awake you should start drinking and eating within 10 to 20 minutes 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.
  • Good pain relief is important. Although some pain-relieving medicines can make you feel sick, severe pain will too.
  • Taking slow deep breaths can help to reduce any feeling of sickness.

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Further reading and references

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