Preventing sickness after surgery (Postoperative nausea and vomiting (PONV) prevention)

What is nausea and vomiting prevention after surgery?

Feeling sick (nausea) or being sick (vomiting) after an operation is one of the most common after-effects of surgery and anaesthesia. Overall, around 1 in 6 people have moderate sickness after an operation, though it depends a lot on the operation, the anaesthetic, and who you are.

Nausea and vomiting prevention is the anaesthetist's plan to make this less likely. It works best as a layered approach: assessing your personal risk, choosing anaesthetic and pain-relief methods less likely to cause sickness, and giving one or more anti-sickness medicines (called anti-emetics), often in combination because that works better than a single drug.

It matters because sickness is not just unpleasant — it can make pain worse, delay eating and drinking, and keep you in hospital longer. Rarely, severe vomiting can strain the operation site or cause other problems.

Prevention reduces the risk but cannot remove it completely. If you do feel sick, the same measures are used to treat it, and it usually settles quickly. Telling your anaesthetist about past sickness or travel sickness genuinely helps them plan.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Single anti-sickness drug vs layered prevention

For people at higher risk of sickness, combining measures works better than relying on one drug.

Preparing for your treatment

• Tell your anaesthetist if you have felt sick after an operation or anaesthetic before, or if you suffer from travel sickness.
• Mention any anti-sickness medicine that has worked well or badly for you in the past.
• Follow your fasting instructions but do not starve yourself for longer than told, as being without food and drink can itself cause sickness.
• Let the team know if you are very anxious, as anxiety can make sickness more likely.
• Ask whether your operation is one that tends to cause more sickness, and what the plan is.
• If you are going home the same day, plan a calm, comfortable journey, as you are more prone to travel sickness afterwards.

What happens

Before your operation, your anaesthetist assesses how likely you are to feel sick, based on your history, the operation and the anaesthetic planned. They then build prevention into your anaesthetic.

This usually means giving one or more anti-sickness medicines around the time of surgery — as a tablet beforehand, or into your vein during the anaesthetic. A combination is often used because it is more effective than a single drug. Where it suits you, they may also choose a regional anaesthetic or anaesthetic drugs less likely to cause sickness, and combine pain-relief methods to reduce strong opioids.

In recovery, the nurses watch for sickness and can treat it quickly with the same medicines and with fluids. It is much easier to settle sickness early, so you are encouraged to say as soon as you feel queasy rather than waiting.

Once you are awake, gently restarting drinking and then light food usually helps recovery, unless your operation means you need to wait — the team will advise.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

Anti-sickness medicines are generally safe, with side effects that are usually minor and short-lived. The main thing to know is that even a good plan cannot guarantee you will not feel sick. Tell your anaesthetist about previous sickness so they can tailor the plan, and speak up early in recovery if you feel queasy, as it is far easier to treat before it gets bad.

Published figures to discuss

How likely sickness is, and how well prevention works, depend on your personal risk factors, the operation and the anaesthetic. The figures below come from large studies, but your own risk may be higher or lower, and prevention reduces rather than removes the chance of sickness.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

This is preventive care woven into your anaesthetic, so there is nothing separate to recover from. If sickness does occur, it usually settles within an hour or two with treatment.

• Feeling a little queasy that settles with rest and medicine.
• Mild drowsiness or a dry mouth from anti-sickness medicines.
• Preferring small sips and light food at first.
• Being more sensitive to travel sickness on the journey home after a general anaesthetic.

Aftercare

• Tell the nurses as soon as you feel sick, rather than waiting for it to get worse.
• Avoid sitting up or getting out of bed too quickly.
• Start with small sips of water and build up slowly to light meals once you are able.
• Take pain relief as advised, since severe pain itself can cause sickness.
• Try slow, deep breaths, which can ease the feeling of sickness.
• If you are going home, plan a calm journey and keep any anti-sickness advice to hand.

• Anaesthetist told about previous sickness or travel sickness
• Fasting instructions understood (and not over-fasting)
• Plan discussed for a higher-sickness operation, if relevant
• Calm journey home arranged if a day case
• Any take-home anti-sickness advice noted
• Contact number saved in case sickness persists at home

⚠ Get urgent help if…

• Vomiting that will not stop, or being unable to keep any fluids down.
• Severe pain made worse by retching or vomiting.
• Vomiting blood, or vomit that looks like coffee grounds.
• Signs of dehydration — very little urine, dizziness, a dry mouth that does not improve.
• Severe headache, a stiff neck or feeling very unwell.
• Any rash, swelling or breathing difficulty after a medicine — seek urgent help.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is simple: you wake up and recover without troublesome sickness, or any sickness is mild and quickly settled, so you can drink, eat and go home on time. Prevention makes this more likely but cannot guarantee it, because individual responses vary.

If you do feel sick despite prevention, it is not a failure — the same medicines treat it, and it usually passes within an hour or two.

This care relates only to the period around your operation. If you have surgery again, it is worth reminding the new team about any sickness you had before, as your anaesthetic can be tailored each time.

Related tests, treatments or support

Sickness prevention is part of wider anaesthetic care and sits alongside multimodal pain relief, regional nerve blocks and enhanced recovery, all of which can reduce sickness by limiting strong opioids and getting you eating and moving sooner.

Follow-up & long-term care

Most sickness is dealt with in recovery before you leave. If you are at higher risk or go home the same day, you may be given advice or anti-sickness medicine to take, and a number to call if sickness continues at home.

Repeat, follow-on and what comes next

• If one anti-sickness medicine does not work, another or a combination can be tried.
• Sickness may recur and need repeat treatment.
• Prevention plans can be adjusted for future operations based on how you responded.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Quick treatment of sickness in recovery, before it becomes severe.
• A clear plan for sips, fluids and gentle return to eating.
• Take-home advice and anti-sickness medicine for higher-risk day cases.
• A named contact route if sickness continues at home.
• A record of what worked, to guide future anaesthetics.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• It is usually built into the anaesthetic fee rather than charged separately.
• The number and type of anti-sickness medicines used.
• Whether pain-relief choices such as nerve blocks are used to reduce strong opioids.
• The type of anaesthetic chosen for your operation.
• Any take-home anti-sickness medicine if you are a day case.

• Confirmation that sickness prevention is included in the anaesthetic fee.
• Whether anti-sickness medicines are included.
• Whether pain-relief techniques that reduce sickness (such as nerve blocks) are included.
• Any charge for take-home anti-sickness medicine.
• Who to contact if sickness continues after you go home.
• What happens if sickness delays your discharge.

On the NHS? Preventing and treating sickness after surgery is a standard part of anaesthetic care on the NHS and privately, and is not normally a separate paid-for service.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Based on my history and operation, how likely am I to feel sick afterwards?
• What will you do to prevent sickness in my case?
• Which anti-sickness medicines will I have, and do they have side effects for me?
• Could a regional anaesthetic or nerve block reduce my sickness?
• What should I do if I still feel sick in recovery or at home?
• When can I safely start eating and drinking after my operation?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for preventing sickness after surgery

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: RCoA — Feeling sick and being sick (risk leaflet) RCoA — Anaesthesia and risk SNAP-1 patient-reported outcomes study (PubMed) Consensus guidelines for managing PONV (PMC) NICE — Nausea and vomiting (BNF antiemetic prescribing guidance) NICE NG180 — Perioperative care in adults (2020)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.