Rescue Treatment of Postoperative Nausea and Vomiting: A Systematic Review of Current Clinical Evidence

Anesth Analg. 2022 Nov 1;135(5):986-1000. doi: 10.1213/ANE.0000000000006126. Epub 2022 Sep 1.


Although prophylactic antiemetics are commonly used perioperatively, an estimated 30% of surgical patients still suffer from postoperative nausea and vomiting (PONV). Very few prospective trials have studied rescue treatment of PONV after failure of prophylaxis, providing limited evidence to support clinical management. In patients who have failed PONV prophylaxis, administering a rescue antiemetic from the same drug class has been reported to be ineffective. For many antiemetics currently used in PONV rescue, significant uncertainty remains around the effective dose range, speed of onset, duration of effect, safety, and overall risk-benefit ratio. As prompt, effective PONV rescue after failure of prophylaxis is important to optimize postoperative recovery and resource utilization, we conduct this systematic review to summarize the current evidence available on the topic.

Publication types

  • Systematic Review

MeSH terms

  • Antiemetics* / therapeutic use
  • Humans
  • Postoperative Nausea and Vomiting* / drug therapy
  • Postoperative Nausea and Vomiting* / prevention & control
  • Prospective Studies


  • Antiemetics