Which of the following procedures in a 5-year-old child would have the least incidence of postoperative nausea and vomiting?

Which of the following procedures in a 5-year-old child would have the least incidence of postoperative nausea and vomiting?

• A. Tonsillectomy
• B. Strabismus surgery
• C. Myringotomy tube placement
• D. Inguinal herniorrhaphy

Answer: (C)

Postoperative nausea and vomiting in children tracks closely with how much surgical stress the procedure creates and how long the child is exposed to anesthesia. Short, minimally invasive surgeries with little tissue trauma tend to produce far less PONV than longer, more painful operations. My ringotomy tube placement fits that pattern. It is a brief ENT procedure with minimal tissue disturbance and postoperative pain, so there’s relatively little trigger for nausea and vomiting after the operation. It often uses light anesthesia and requires less opioid exposure, further lowering PONV risk. In comparison, tonsillectomy, especially with adenoidectomy, involves significant oropharyngeal tissue manipulation and pain, which raises PONV risk. Strabismus surgery involves eye muscle manipulation and can have higher emetogenic triggers as well. Inguinal herniorrhaphy is longer and more painful than an ear tube procedure, giving it a higher PONV risk than ear tube placement but typically lower than tonsillectomy or strabismus surgery. So, the ear tube placement has the least incidence of postoperative nausea and vomiting among these options.

Postoperative nausea and vomiting in children tracks closely with how much surgical stress the procedure creates and how long the child is exposed to anesthesia. Short, minimally invasive surgeries with little tissue trauma tend to produce far less PONV than longer, more painful operations.

My ringotomy tube placement fits that pattern. It is a brief ENT procedure with minimal tissue disturbance and postoperative pain, so there’s relatively little trigger for nausea and vomiting after the operation. It often uses light anesthesia and requires less opioid exposure, further lowering PONV risk.

In comparison, tonsillectomy, especially with adenoidectomy, involves significant oropharyngeal tissue manipulation and pain, which raises PONV risk. Strabismus surgery involves eye muscle manipulation and can have higher emetogenic triggers as well. Inguinal herniorrhaphy is longer and more painful than an ear tube procedure, giving it a higher PONV risk than ear tube placement but typically lower than tonsillectomy or strabismus surgery.

So, the ear tube placement has the least incidence of postoperative nausea and vomiting among these options.