Factors affecting nausea and vomiting in the plastic surgery patient.

In plastic and reconstructive surgery, nausea and vomiting are annoying and often dangerous phenomena, yet attempts to suppress them therapeutically may cause physiological actions of an undesirable nature. Nevertheless, it is possible, through clinical observation and the taking of a careful history, to identify many patients who are at highest risk of suffering undue damage from emetic episodes. Skillful selection of surgical and anesthetic measures that safely limit provocation of the vomiting reflex and the careful use of effective antiemetic drugs in patients particularly at risk can effectively reduce the incidence of what may be our patient's most unpleasant and dangerous perioperative experience.