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Postoperative nausea and vomiting following orthognathic surgery
C Phillips1, C D Brookes2, J Rich1
1Department of Orthodontics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Postoperative nausea and vomiting (PON/POV) remain common after orthognathic surgery. Key risk factors include female gender, increased fluids, nitrous oxide, race, additional procedures, and morphine, with incidence rates unchanged despite updated guidelines.
Area of Science:
- Anesthesiology
- Oral and Maxillofacial Surgery
Background:
- Postoperative nausea and vomiting (PON/POV) are frequent complications following orthognathic surgery.
- Updated consensus guidelines for PON/POV management were introduced in 2007.
Purpose of the Study:
- To evaluate the incidence and identify risk factors for PON and POV after orthognathic surgery.
- To assess the impact of updated 2007 guidelines on PON/POV rates.
Main Methods:
- Retrospective review of 204 patients undergoing orthognathic surgery (2008-2012).
- Logistic regression models analyzed patient-related, intraoperative, and postoperative factors.
- PON and POV occurrence were assessed separately.
Main Results:
- Incidence rates were 67% for PON and 27% for POV.
- Significant risk factors for PON included female gender, increased IV fluids, and nitrous oxide.
- Risk factors for POV included race, additional procedures, and morphine administration.
Conclusions:
- PON and POV incidence after orthognathic surgery have not substantially decreased post-2007 guidelines.
- Identifying specific risk factors is crucial for targeted PON/POV management strategies.
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