Date of Award


Document Type


Degree Name

Master of Science (MS)




Postoperative nausea and vomiting (PONV) causes distress and anxiety to the pediatric patient. PONV can lead to dehydration, disruption of the incision site, delayed discharge and cause unanticipated hospitalization after ambulatory surgery. The reported incidence of PONV in children can be up to twice that of the adult patient. There are many different strategies used in treating or preventing pediatric PONV including pharmacologic, nonpharmacologic, homeopathic, and multi-modal therapies. Because of the complex nature of PONV, it is necessary to approach its treatment with a rational management. The purpose of this thesis was to compare different treatment techniques for PONV on pediatric patients, by North Dakota certified registered nurse anesthetists (CRNAs). The data was then compared with the PONV low and high-risk algorithms created by Mott Children’s Hospital. These algorithms categorize pediatric surgical patients into either low-risk or high-risk candidates for PONV. The algorithms are evidence based and were formulated to reduce over and under use of antiemetics, promote cost efficiency, and to promote the appropriate use of either single dose versus multimodal therapy in treating pediatric PONV.

A survey was sent to all practicing CRNAs in North Dakota. The survey questioned North Dakota CRNAs preventative, rescue, and treatment techniques for pediatric PONV. The returned surveys were analyzed and compared to the Mott Children’s Hospital algorithms. The results of this study showed minimal variation in practice among anesthesia providers in North Dakota as compared to the evidence based Mott Children's Hospital algorithms. Variations were identified in the two areas of gender and years of experience as a practicing CRNA. When studying the appropriateness of treatment of pediatric PONV as compared to the Mott Children’s Hospital algorithm, North Dakota CRNAs were treating pediatric patients appropriately.

Data were further analyzed using chi-square to identify if a difference occurred in gender or years of experience when treating pediatric PONV. Analysis of the data indicated that there was a relationship but it was not of significance.