Which approach reduces postoperative nausea and vomiting?

• A. Relying on opioids for pain control
• B. Prolonged NPO
• C. Hyperhydration
• D. Multimodal analgesia with antiemetic prophylaxis

Answer: (D)

Reducing postoperative nausea and vomiting comes from a strategy that both lowers opioid use and preemptively blocks nausea pathways. By using multimodal analgesia—non-opioid pain meds, regional techniques, and other non-opioid strategies—you achieve pain control while minimizing the opioid dose that often triggers nausea. Adding antiemetic prophylaxis that targets multiple receptors (for example, blocking serotonin, substance P/NK1, and incorporating steroids) helps prevent nausea before it starts. Together, these elements address several mechanisms behind PONV and reduce its incidence more reliably than relying on opioids alone, keeping patients better hydrated and recovering sooner. Prolonged NPO and hyperhydration alone don’t provide the same comprehensive prevention or reduction of PONV.