A 60-year-old man with treated hypertension and type 2 diabetes undergoes uneventful laparoscopic cholecystectomy as a day-case under general anaesthesia. He voids normally, tolerates oral fluids, pain is controlled with paracetamol and NSAIDs, and walks unaided. Which finding would still mandate overnight admission before discharge home?
- A Persisting nausea and vomiting despite two doses of antiemetics ✓
- B Intraoperative use of ondansetron for a single episode of nausea
- C Use of short-acting neuromuscular blockade reversed fully
- D Surgery duration exceeding 90 minutes
Correct answer: A. Persisting nausea and vomiting despite two doses of antiemetics
Explanation
Refractory postoperative nausea and vomiting despite adequate antiemetic prophylaxis and treatment is a recognised reason to cancel discharge, since vomiting prevents oral intake and hydration and predicts readmission. Single-agent antiemetic use, full reversal of neuromuscular block, and surgical duration are not discharge barriers by themselves. Standard criteria require control of symptoms, not merely their occurrence.
Reference: Miller's Anesthesia, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.