Food Related Video and the Incidence of Postoperative Nausea and Vomiting

The study will be conducted in 18-40 years old female volunteers who are undergoing planned, elective, non-cancer surgical procedure as outpatients, and who are identified to have either history or significant risk of PONV. The latter will be calculated by the questionnaire we currently use during our routine preoperative anesthesia evaluation (see in detail below in the Study design section).

Patients who meet the study enrollment criteria will be identified on the surgical schedule the day before the planned intervention. The recruitment will occur during the preoperative admission process.

These patients will be randomly assigned to either the study group or to the control group. The study group will watch videos of preparation and cooking of their favorite foods while waiting for their surgery. Patients in the control group will watch videos that are not food related.

The anesthesia team in the OR and the PACU team who manages the patient's postoperative recovery will be blinded to which group the patient is enrolled to. The intraoperative antiemetics will be provided by the study team as outlined in the Study design section below.

The anesthesia protocol will be standardized. All patient who are enrolled in the study will require general anesthesia with endotracheal intubation. After intravenous induction, muscle relaxation with rocuronium and intubation of the trachea anesthesia will be maintained with sevoflurane and opioid boluses for analgesia as deemed necessary by the anesthesia team. Antiemetics (as described below) will be administered 30 minutes prior to planned emergence, residual muscle relaxant will be reversed with sugammadex.

The patients will be taken to the recovery room. Beyond their routine vital sign and pain score monitoring and observation the occurrence and degree of nausea and vomiting, as well as the time to discharge to home or unplanned admission due to therapy resistant vomiting will be recorded.

Inclusion criteria

• 18-40 years old female
• American Society of Anesthesiologists Physical Status I and II
• Personal history of postoperative nausea and vomiting
• Personal history of motion sickness
• Non-smoker status
• Undergoing scheduled elective surgical procedures and general anesthesia for non-cancer surgery of:
• breast
• gynecology
• ear, nose and throat
• eye
• Duration of surgery less than 3 hours will be enrolled in the study.

Exclusion criteria

• Ages older than 40 years and younger than 18 years
• Morbid obesity (BMI > 35 kg/m2)
• Uncontrolled gastroesophageal reflux disease (GERD)
• Smoking
• Cancer and chemotherapy
• Vertigo
• Meniere's disease
• Pseudotumor cerebri and other central nervous diseases that may induce nausea and vomiting
• Prolonged (> 15 minutes) intraoperative hypotension
• Estimated blood loss > 20 % of estimated blood volume
• Emergency surgery