Certified Neuroscience Registered Nurse (CNRN) Practice Exam

Which anesthesia-related factor increases the risk of PONV?

1. Use of local anesthetics

2. Use of volatile gas

3. Use of general anesthesia without opioids

4. Use of minimal sedation

The correct answer is: Use of volatile gas

The use of volatile gas in anesthesia is associated with an increased risk of postoperative nausea and vomiting (PONV). Volatile anesthetics are inhaled agents that are commonly used during general anesthesia. They can affect the central nervous system and are known to stimulate the area postrema, a part of the brain that plays a crucial role in the emetic pathway. This stimulation can lead to nausea and vomiting after surgery. The risk of PONV with volatile anesthetics is compounded by other factors, such as patient demographics, type of surgery, and the use of opioids. Additionally, studies have indicated that patients receiving inhalational agents often report higher levels of PONV compared to those who receive other forms of anesthesia, reinforcing the association between volatile anesthetics and PONV. In contrast, local anesthetics, general anesthesia without opioids, and minimal sedation do not share the same level of association with PONV. Local anesthetics are targeted and generally cause fewer systemic side effects, while general anesthesia without opioids may reduce PONV risk due to less overall sedation and impact on the emetic pathways. Minimal sedation results in a lighter level of anesthesia, further decreasing the likelihood of experiencing PONV. Therefore, the use of volatile gas