Researchers analyzing postoperative nausea and vomiting after general anesthesia for oral and maxillofacial surgery found an overall incidence of 25.3% among 372 patients evaluated between January and December 2011. The retrospective study examined potential risk factors, ranging from patient characteristics to anesthetic and surgical variables, in both inpatient and outpatient settings.
Retrospective Patient Cohort and Surgical Grouping at Mahidol University
Following approval from the Institutional Review Board of the Faculties of Dentistry and Pharmacy at Mahidol University, investigators reviewed 390 patient charts covering all individuals who underwent oral and maxillofacial surgery under general anesthesia between January 2011 and December 2011. The study captured both inpatients and outpatients across a wide age range. From this initial pool, 18 charts were excluded: eight patients had undergone extraoral procedures, seven retained their endotracheal tubes for more than 24 hours, and three contained incomplete medical data.
The final enrollment comprised 372 patients, spanning ages from 2 to 79 years with a mean age of 26 years. To better evaluate demographic patterns, researchers divided the cohort into five distinct age brackets: under 10 years, 11 to 19 years, 20 to 29 years, 30 to 39 years, and over 40 years. Within the analyzed group, 44.6% of the patients were male and 55.4% were female. Procedurally, the majority underwent either minor oral surgery, accounting for 56.6% of the cases, or orthognathic surgery, which made up 33.4%.
Evaluating Anesthetic Techniques, Surgical Factors, and Recorded Variables
Data collection spanned the entire surgical continuum, capturing preoperative traits, intraoperative variables, and postoperative care. Preoperative records noted patient age, sex, body mass index, history of postoperative nausea and vomiting or motion sickness, and smoking status. During operations, teams tracked the duration of anesthesia, nasogastric tube insertion, tube retention duration, and calculated blood loss using volumetry and gravimetry.
Anesthetic maintenance relied on nitrous oxide, sevoflurane, and opioids including morphine, pethidine, or fentanyl across all procedures, while propofol or sevoflurane served as induction agents based on individual patient cooperation. Atracurium or cisatracurium provided neuromuscular blockade and was reversed at the conclusion of anesthesia. Every surgical case involved the placement of a throat pack. The attending surgeon determined whether to insert a nasogastric tube and whether to retain or remove it postoperatively. Postoperative opioid administration was also logged.
Incidence Findings and Analytical Methodology
Postoperative nausea and vomiting was defined strictly as either nausea alone or a combination of nausea and vomiting recorded within 24 hours postoperatively. Across the entire cohort of 372 patients, the overall incidence reached 25.3%, affecting 94 individuals. This aligns with broader surgical literature indicating that postoperative nausea and vomiting affects between 20% and 30% of surgical patients generally, though specific data for oral and maxillofacial procedures had previously remained sparse.
To evaluate potential risk factors, data were coded and processed using the Statistical Package for the Social Sciences, version 13. Continuous variables were expressed as means and standard deviations, while categorical figures were reported as raw numbers. Researchers conducted univariate analyses employing chi-square tests for categorical variables and t-tests for continuous data. Variables demonstrating a p-value below 0.1 advanced to multivariate analysis, where a p-value under 0.05 was required for statistical significance.
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