An effective way of calming post-operative nausea and upset stomach associated with anesthesia and surgery

Post-Operative Nausea and Vomiting (PONV)

Post-operative nausea and vomiting (PONV) is primarily caused by anesthesia and other drugs used in surgical procedures, much of which is elective in the United States.  These include Cesarean-sections for pregnant women, and cosmetic and reconstructive surgeries.  Thus, a significant amount of PONV can be anticipated for patients having elective surgery.

PONV is estimated to occur in about 50% of elective cosmetic surgeries in the US (approximately 6.6 million each year).  Each year about one-third of pregnant women in the United States elect to have a C-section, amounting to about 1.4 million being performed annually.  For such cases, PONV may be frequent and unpleasant, causing significant distress to the patient.

Clinical Trials of Ginger for PONV

Recently, ginger has been studied scientifically for its effect on nausea and vomiting associated surgery (Pongrojpaw et al., 2003).  Six out of the nine studies reviewed demonstrated that ginger is effective in relieving PONV.  In the other three studies, ginger was better than the placebo but showed no difference with the standard of care comparator.

Although effects are promising, there have been inconsistencies as reported in a number of studies on PONV (Arfeen et al., 1995; Bone et al., 1990; Phillips et al., 1993; Visalyaputra et al., 1998).

Potential confounding factors in studies of PONV include the nausea-inducing effect of various anesthetics and short assessment periods, allowing little time for ginger to exert its maximum effects. A meta-analysis of 5 randomized clinical trials (RCTs) including 363 patients found that a fixed dose of at least 1 g of powdered ginger is more effective than placebo in preventing PONV (Chaiyakunapruk, 2006).

Zindol® DS for PONV

Zindol® DS, with appropriate dosing and schedule for anticipated nausea, may be a safe and effective way of calming post-operative nausea and upset stomach associated with anesthesia and surgery.

References:

• Arfeen Z, Owen H, Plummer J, Ilsley A, Sorby-Adams R and Doecke C. (1995). A double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting. Anaesth Intensive Care. 23(4): 449-52.
• Bone M, Wilkinson D, Young J, McNeil J and Charlton S. (1990). Ginger root–a new antiemetic. The effect of ginger root on postoperative nausea and vomiting after major gynaecological surgery. Anaesthesia. 45(8): p. 669-71.
• Chaiyakunapruk N, Kitikannakorn N, Nathisuwan S, Leeprakobboon K and Leelasettagool C. (2006). The efficacy of ginger for the prevention of postoperative nausea and vomiting: a meta-analysis. Am J Obstet Gynecol. 194(1): 95-9.
• Phillips S, Ruggier R and Hutchinson S. (1993). Zingiber officinale (ginger)–an antiemetic for day case surgery. Anaesthesia. 48: p. 715-717.
• Pongrojpaw D and Chiamchanya C. (2003). The efficacy of ginger in prevention of post-operative nausea and vomiting after outpatient gynecological laparoscopy. J Med Assoc Thai. 86(3): 244-50.
• Visalyaputra S, Petchpaisit N, Somcharoen K and Choavaratana R. (1998). The efficacy of ginger root in the prevention of postoperative nausea and vomiting after outpatient gynaecological laparoscopy. Anaesthesia. 53(5): 506-10.