Is Vomiting After Rhinoplasty Common?

Question

I have a huge fear of vomiting and I've heard that some people are sick during recovery from rhinoplasty because of the anesthesia or from swallowing blood. How common is this and can it be prevented?

Etai Funk, MD · Answer

Nausea and vomiting after rhinoplasty can occur due to even a small amount of blood irritating the stomach. This can sometimes be prevented with the placement of something called a throat pack. Once you are asleep and under general anesthesia, a long string of guaze is placed in the throat to catch any of the blood coming down from the nose. Once the procedure is complete, the guaze is removed. This can only be done if your rhinoplasty is under general anesthesia and you are intubated (breathing tube). Otherwise, you would not tolerate placement of this guaze and it would also compromise your airway. Antinausea medications such as Zofran or Phenergan can also help.

Lewis Albert Andres, MD · Answer

Thank you for your question. Postoperative nausea and vomiting is not an uncommon phenomenon in Surgery, especially with general anesthesia. Certain procedures, such as a rhinoplasty, have a slightly higher incidence of such, approximately 10%.While it is nearly impossible to determine your chance of vomiting after this procedure, there are some measures that can be taken to help reduce the possibility. Things such as what you mentioned (antiemetics and a patch) are helpful. Discussing your history of nausea/vomiting with your anesthesiologist is useful, as s/he can ensure that you are well-hydrated, given intraoperative anti-nausea medications, steroids, and given anesthesia least prone to postoperative nausea and vomiting. Lastly, blood within the stomach is a stimulant for such issues, so minimizing secretions into the stomach as well as aspirating prior to awakening are important. Hope that this helps!  Best wishes for a wonderful result!

Sam Rizk, MD · Answer

Nausea and vomiting after rhinoplasty can occur from either a response to an anesthetic or blood dripping into the stomach. I have devised a method to prevent blood going into the stomach, and although my anesthesiologist gives many medicines to prevent nausea and vomiting, it still can occur with a rate in my practice of about 5 percent despite all anti-nausea medications given.

Richard W. Westreich, MD · Answer

As you suggest, anesthesia and blood in the stomach are the most common causes of vomiting.

	Personally, I believe that twilight anesthesia reduces nausea after surgery. Intravenous medications and anti-vomiting pills can also be given to help reduce the likelihood of nausea after surgery.

	One thing you can do is ask family members how they reacted to general anesthesia. If your parents and/or siblings did not have severe nausea after anesthesia, then it is likely you will not have vomiting issues either.

	Hope this helps and best of luck.

Sam Speron, MD, FACS · Answer

After having Rhinoplasty surgery, you can experience nausea/vomiting. There's three main causes. The first can be from the anesthesia, which can last up to a few hours post operation. Also, the vomiting can be related to swallowing blood or the pain medicine you're prescribed. We would prescribe anti-nausea(Zofran), the drug currently available for preventing nausea or vomiting, that is taken the day of surgery. Your plastic Surgeon will discuss any options with you during your consultation.

Otto Joseph Placik, MD · Answer

There are numerous methods to minimize nausea and vomitting after surgery and you should discuss your fears with your surgeon. However, this is not always entirely avoidable despite the best of techniques.

Eric M. Joseph, MD · Answer

You may experience nauseusness and vomiting after Rhinoplasty Surgery despite anti-emetic medications to prevent this. It's mostly from blood that makes its way down into your stomach during your surgery. Even a small amount of blood in the stomach is nauseating for patients, and I have found this difficult to avoid in approximately 30% of my patients. Suctioning the contents of your stomach at the end of your Rhinoplasty with a Salem-sump tube may be beneficial.

	I hope this is helpful for you.

David C. Pearson, MD · Answer

While everyone responds to anesthetics differently, modern anesthesia is associated with a MUCH lower incidence of post-op nausea and vomiting than in even the recent past.

	As for the contribution of swallowed blood, we usually minimize this by minimizing bleeding during surgery, suctioning out any blood from the throat at the end of the case, and encouraging patients post-operatively to drink plenty of fluids (i.e., "the solution to pollution is dilution!")

	All the best,

	--DCP

David Shafer, MD, FACS · Answer

In the past, nausea after surgery was common. However, there are several medications now that are very effective in treating post operative nausea and vomiting. If you discuss your concerns with your doctor and your anesthesiologist they will be able to help you have a comfortable post operative recovery. Good luck.

Ryan Greene, MD, PhD · Answer

It is very rare for a patient to vomit after a rhinoplasty. Vomiting typically occurs if the anesthesiologist was too generous with narcotic use during the surgery, or from swallowing blood. There is very little bleeding during a rhinoplasty, so it is rare for a patient to swallow much blood. I also have the anesthesiologist give the patient an anti-emetic (Zofran) prior to awakening from anesthesia. I cannot even remember the last time one of patients vomited after a rhinoplasty, so this should not be a deterrent for you.

Is Vomiting After Rhinoplasty Common?

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