10+ Year Member
7+ Year Member
- Feb 20, 2005
What's everyone's favorite TIVA regimen for severe PONV. Also, would your plan change if you were at a surgery center.
Precedex, ketafol, magnesium. Don't let systolics drop below 120 or keep even higher if autoregulation curve is shifted to the right. Make sure the tank is full. Decadron up front. Reglan, zofran 15 minutes before extubation. Toradol + minimal to no narcotics (choose short acting ones if need be). Keep patient at .5 Mac (not a true tiva). Try not to use paralytics (and therefore neostigmine). LMA over ETT. Suction stomach if blood has made it's way down there for whatever reason.What's everyone's favorite TIVA regimen for severe PONV. Also, would your plan change if you were at a surgery center.
To be honest, I haven't run that many TIVA's solely for severe PONV. I was just detailing my TIVA regimen; Have run more TIVA's for h/o MH than PONV. I don't have a big enough "n" to know if a narcotic GTT added to TIVA would result in PONV. How 'bout you? Any experience w/ the GTT's causing problems?No problems running opiod gtt for PONV?