Ambulatory surgery is occurring with rapidly increasing frequency as surgical and anesthetic
techniques have improved and pressure to reduce health-care costs has increased. While there
are many benefits to recovering from surgery within the home, a significant disadvantage is
the lack of rapid access to a healthcare provider when postoperative complications occur.
Postoperative nausea and vomiting (PONV) are common after surgery and anesthesia, and recent
studies have demonstrated a high incidence of post-discharge nausea and vomiting (PDNV) after
ambulatory surgery, particularly in high-risk groups (female gender, age less than 50 years,
history of PONV, opioid administration in the post-anesthesia care unit (PACU), and nausea in
the PACU). Current practices known to reduce the risk of postoperative nausea and vomiting in
the PACU, such as the avoidance of volatile anesthetics and the use of intraoperative
ondansetron and steroids, have little effect on the risk of delayed PDNV. Novel strategies to
prevent PDNV are needed. Orally administered olanzapine, which has been shown to decrease the
incidence of chemotherapy-induced nausea and vomiting, demonstrates promise as a novel
strategy for preventing PDNV. It has a long half-life, allowing for a single dose to be
administered preoperatively. This study will evaluate whether there is a difference in the
incidence and severity of PDNV between patients who receive oral olanzapine versus placebo
prior to general anesthesia for ambulatory surgery.