Postoperative nausea and vomiting after oral and maxillofacial surgery: a prospective study

Abstract

Postoperative nausea and vomiting (PONV) is one of the most unpleasant experiences after surgery. It reduces patient satisfaction and also increases hospital costs due to longer hospitalizations. The aim of this prospective study was to determine whether orthognathic surgery is associated with more PONV than less invasive maxillofacial surgery. Three hundred and eight patients aged 8-87 years who underwent maxillofacial surgery were included. The PONV score, based on the Apfel score, was calculated preoperatively. PONV occurred in 142 (46.1%) patients during the first three postoperative days; these patients were further categorized as having postoperative nausea (PON) and/or postoperative vomiting (POV). PON was most frequent after orthognathic surgery to the mandible (75%), and POV was most frequent after maxillary surgery, including bimaxillary surgery, Le Fort I osteotomy, and surgically assisted rapid palatal expansion (SARPE) (43.1%). There was a small significant relationship between the preoperative PONV score and the incidence of PONV: patients experienced more PONV when the PONV score calculated preoperatively was higher. The incidence of PONV after orthognathic surgery was very high compared with the incidence after dental extractions and other minor surgeries. Further investigation is required to establish a strategy to reduce PONV after orthognathic surgery.

Penehyclidine for prevention of postoperative nausea and vomiting following bimaxillary orthognathic surgery: a randomized, double-blind, controlled trial

“…We, therefore, tested the hypothesis that a bolus plus infusion administration of penehyclidine could be more effective in reducing PONV. In the present study, 61.0% of patients in the Control group experienced PONV within 72 h following bimaxillary surgery; this was in line with previous studies in a similar patient population [ 5 , 28 ]. Compared with the Control group, patients given a single bolus penehyclidine (Bolus group) had a 34% lower incidence of PONV within 72 h, close to the effect reported by Sun and colleagues [ 15 ].…”

“…> 0.999 [5,28]. Compared with the Control group, patients given a single bolus penehyclidine (Bolus group) had a 34% lower incidence of PONV within 72 h, close to the effect reported by Sun and colleagues [15].…”

“…Compared with single-jaw surgery, bimaxillary surgery is followed by an even higher incidence of PONV despite antiemetic prophylaxis [ 4 ]. In a prospective cohort study, 72.2% of patients experienced nausea and 43.1% developed vomiting after bimaxillary surgery [ 5 ]. Occurrence of PONV may be life-threatening in bimaxillary patients; maxillomandibular elastic tractions, facial swelling and pain may all affect mouth-opening, increase the risk of aspiration and lead to asphyxia [ 6 ].…”

Complicaciones, eficacia y nivel de satisfacción en procedimientos ambulatorios de Cirugía Oral y Maxilofacial

“…El tipo de complicaciones dependió del lugar en el que ocurrieron, así en quirófano las más frecuentes fueron la hipotensión y el laringoespasmo, mientras que en URPA fueron el dolor y las náuseas y en UCMA el dolor y el mareo. Estos resultados son semejantes a lo publicado por otros autores [11][12][13][14] .…”

“…Las náuseas y vómitos postoperatorios son cada vez menos frecuentes desde que se emplean técnicas preventivas como la realización de taponamiento nasofaríngeo durante la anestesia general, el tratamiento con antieméticos como los esteroides o drogas específicas como el ondasetrón, y la restricción de anestésicos volátiles y opioides. El uso de técnicas de anestesia local y sedación en lugar de la anestesia general han contribuido también a disminuir su incidencia [10][11][12][13] .…”