A high percentage of anesthetized patients are nauscated and vomit in the postoperative period. Such a common phenomenon cannot be considered a complication.

Aspiration of Vomitus

Aspiration of Vomitus is a serious complication that must be prevented by emptying the stomach before inducing anesthesia ( with a nasogastric tube when necessary ). Turning the patient on his side with the head lowered when vomiting occurs may prevent this complication.

Paralytic Ileus

Temporary cessation of peristalsis of the gastrointestinal tract occurs after anesthesia, trauma, and abdominal operations. If it becomes sustained, electrolyte imbalance, wound infections, or some metabolic disturbance ( myxedema or adrenal failure ) may be the cause. Nasogastric suction and fluid replacement will correct most cases.

Acute Gastric Dilation

Acute gastric dilation is and uncommon complication that may follow abdominal, chest, spine, or central nervous system procedures. The precise cause is obscure. An astonishing amount (several liters ) of gas and dark, foul material may collect in the stomach. Vomiting and distension are the main diagnostic points. The vomiting, which is seldom accompanied by retching, features an overflow type of regurgitation that, curiously, may not be attended with nausea.

The distension may rapidly progress to fatal cardiovascular collapye within hours. Immediate intubation of the stomach and aspiration of its contents and fuid and electrolyte replacement may be life saving. Aspiration of 2 liters or more of gas and liquid material virtually assures the diagnosis of acute gastric dilation. Continuous decompression will usually relieve the gastric

dilation immediately and reverse the gastric atony within 48 hours. The surgeon can safely discontinue aspiration at that time if no mechanical obstruction coexists.

Hiccup

Hiccuping in the postoperative patient may indicate some potentially serious underlying problems; this is its chief significance. Most commonly hiccups are a shortlived nuisance and nothing more. Abscesses near the diaphragm, uremia, gastric dilation, paralytic ileus, peritonitis, anxiety, and acidosis are the more common conditions that cause these spasms of the diaphragm. Rarely hiccups may persist for days or weeks and utterly exhaust the sufferer. Correcting the associated disease is the obvious and Jogical treatment. Vagal pressure, rebreathing air or carbon dioxide, sedation, or tranquilization may bring symptomatic relief.

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