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Incidence and risk factors for postoperative nausea and vomiting in orthognathic surgery: a 10-year retrospective study

대한구강악안면외과학회지 2020년 46권 2호 p.116 ~ 124
 ( Ghosh Subhabrata ) - Bapuji Dental College and Hospital Department of Oral and Maxillofacial Surgery

 ( Rai Kirthi Kumar ) - Bapuji Dental College and Hospital Department of Oral and Maxillofacial Surgery
 ( Shivakumar Hosadurga Rudraswamy ) - Bapuji Dental College and Hospital Department of Oral and Maxillofacial Surgery
 ( Upasi Amarnath P. ) - Bapuji Dental College and Hospital Department of Oral and Maxillofacial Surgery
 ( Naik Vinayak Gourish ) - Bapuji Dental College and Hospital Department of Oral and Maxillofacial Surgery
 ( Bharat Avijit ) - Bapuji Dental College and Hospital Department of Oral and Maxillofacial Surgery

Abstract


Objectives: Postoperative nausea and vomiting (PONV) is considered as one of the most incessant and anguishing factors for patients who have surgery under general anesthesia. The occurrence of PONV after orthognathic surgery can lead to dehydration, infection, bleeding at the surgical site, and patient discomfort, all of which leave a patient with a negative impression of anesthesia and surgery. The purpose of this study is to assess the incidence of PONV after orthognathic surgery and to correlate it with factors related to patient, anesthesia, and surgery.

Materials and Methods: A 10-year retrospective survey was done for patients who underwent orthognathic surgery between January 2008 and March 2018. The incidence of PONV was evaluated, correlations with factors related to patient, anesthesia, and surgery were studied, and the duration between the end of surgery and the occurrence of the first episode of PONV was tabulated.

Results: The medical records of 109 patients were screened, out of which 101 satisfied the inclusion criteria. Amongst these patients, 60 patients (59.4%) suffered from PONV. Patient’s sex, induction agent used, intravenous fluids administered intraoperatively, duration and type of surgery, and the presence of a nasogastric tube were seen to have a significant influence on precipitating PONV. It was noted that among the patients who suffered from PONV, 61.7% of them experienced it 48-96 hours after the end of surgery.

Conclusion: Despite the improved anesthetic equipments, drugs, and surgical techniques currently used, the incidence of PONV was high in our study. Certain factors that were seen to influence PONV in this study need to be considered in order to develop an efficacious protocol to reduce PONV in orthognathic surgeries.

키워드

Postoperative nausea and vomiting; Orthognathic surgery; General anesthesia
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