What is the first-line treatment for post-operative nausea and vomiting in surgical patients?

Ondansetron is recognized as the first-line treatment for post-operative nausea and vomiting (PONV) due to its effectiveness and safety profile. It is a selective serotonin (5-HT3) receptor antagonist that works by blocking the action of serotonin, which can trigger nausea and vomiting in the central nervous system and gastrointestinal tract.

In surgical patients, especially those undergoing procedures with a higher risk for PONV, ondansetron has a well-established role in prevention. Its rapid onset and ease of administration make it a preferred choice for managing these symptoms in the post-operative setting. Moreover, it has a favorable side effect profile when compared to other antiemetics, which improves patient comfort and recovery.

Other treatments, such as metoclopramide, dexamethasone, and granisetron, have their own roles in managing nausea and vomiting, but they may not be the first-line options for all surgical patients. Metoclopramide, for example, is a prokinetic agent that can also help with nausea, but it may have more side effects, like drowsiness or extrapyramidal symptoms. Dexamethasone, a corticosteroid, can be used as part of a comprehensive approach to PONV,