support. "I needed a solid physician champion, and he was totally
onboard with the study, as were his patients," says Ms. Landmesser.
The ongoing study will compare aromatherapy to traditional
antiemetic during early PONV, defined as 2 to 6 hours after surgery
(Phase I recovery). Ms. Landmesser will evaluate 100 patients
before tabulating the results.
If you're worried about convincing a skeptical surgical board about
the viability of something like aromatherapy, you shouldn't be. As Ms.
Landmesser points out, even the American Society for
Anesthesiologists (ASA) has built a non-traditional antiemetic (aro-
matherapy) into its algorithm for PONV treatment.
"If key organizations and key leaders are looking into aromatherapy
as an alternative then we, too, need to study this as healthcare
providers," says Ms. Landmesser. "You need to impress upon those
who may not have experience in the surgical arena that we need to
have alternatives in the OR."
N O V E M B E R 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 8 7
tor agonist. The IV opioid, manufactured by Trevena, is in the new
class of analgesics called opioid-selective agonist. While the drug
demonstrated reduced nausea and vomiting in clinical trials
compared with morphine, the committee said the proposed dos-
ing may not be enough to manage pain and that higher doses
could increase the risk of respiratory depression. Although
oliceridine works on the neural receptors like other opioids, it
also activates a pathway called the beta-arrestin pathway. This
reduces such opioid-related side effects as depression, nausea
and vomiting. The FDA isn't required to follow its advisory com-
mittees, but it usually does.
— Outpatient Surgery Editors
