Maksillofasiyal cerrahiden sonra gelişen postoperatif bulantı kusma için risk faktörleri

Yıl 2023, Cilt: 28 Sayı: 3, 357 - 363, 28.09.2023

Alanur Çiftçi Şişman , Hazal İrem Çiftçi , Necip Fazıl Erdem

https://doi.org/10.21673/anadoluklin.1342640

Öz

Amaç: Bu çalışmanın amacı maksillofasiyal cerrahide postoperatif bulantı ve kusma için risk faktörlerini belirlemek ve önlenmesine katkıda bulunmaktır.

Yöntemler: Çalışmaya genel anestezi altında maksillofasiyal cerrahi operasyon geçirmiş 93 hasta (42 kadın, 51 erkek) dahil edildi. Hiçbir hastaya postoperatif kurtarıcı antiemetik ilaç verilmedi. Veri toplamak amacıyla hastayla ilgili, anestezi ile ilgili ve cerrahi operasyon ile ilgili değişkenler kaydedildi. Bulantı ve kusmadan en az birinin varlığı postoperatif bulantı ve kusma vakası olarak tanımlandı. Postoperatif bulantı ve ağrı, Görsel Analog Skala ile değerlendirildi. Cerrahi operasyon sonrası ilk 24 saatteki toplam kusma sayısı ve hastanede kalış gün sayısı kaydedildi.

Bulgular: Postoperatif bulantı ve kusma ile en fazla ilişkili risk faktörleri kadın cinsiyet, artmış intraoperatif kanama, uzamış operasyon süresi, submental entübasyon ve postoperatif ağrı olarak bulundu.

Sonuç: Yaygınlığı ve önemli sonuçları göz önüne alındığında, postoperatif bulantı ve kusmanın önlenmesi önemli bir husustur. Bu bakımdan risk faktörlerinden bir veya daha fazlasına sahip hastalarda ameliyat öncesi ve sonrası önlem alınması faydalı olabilir.

Anahtar Kelimeler

Anestezi, oral cerrahi, postoperatif komplikasyonlar, postoperatif mide bulantısı ve kusma

Risk factors for postoperative nausea and vomiting following maxillofacial surgery

Öz

Aim: The aim of this study was to determine the risk factors for postoperative nausea and vomiting (PONV) in maxillofacial surgery and contribute to its prevention.

Methods: 93 patients (42 female, 51 male) who underwent maxillofacial surgery under general anesthesia were included in the study. No postoperative rescue antiemetic medications were given to patients. One investigator recorded patient-related anesthesia-related and surgery-related variables. The nausea and pain were evaluated postoperatively by means of Visual Analogue Scale. Total number of vomiting in the first 24 hours after surgery and number of days of hospital stay were recorded.

Results: The risk factors most associated with postoperative nausea and vomiting were found to be female sex, increased bleeding, submental intubation, prolonged operation time, and postoperative pain. No significant relationship was found between smoking, age, BMI, receiving GA for the first time and PONV in context of maxillofacial surgery.

Conclusion: Given its prevalence and significant consequences, prevention of postoperative nausea and vomiting is an important consideration. It may be useful to take preoperative and postoperative precautions in patients with one or more risk factors.

Anahtar Kelimeler

Anesthesia, oral surgery, postoperative complications, postoperative nausea and vomiting

Kaynakça

• Dobbeleir M, De Coster J, Coucke W, et al. Postoperative nausea and vomiting after oral and maxillofacial surgery: a prospective study. Int J Oral Maxillofac Surg. 2018;47(6):721-5.
• Stadler M, Bardiau F, Seidel L, et al. Difference in Risk Factors for Postoperative Nausea and Vomiting. Anesthesiology. 2003;98(1):46-52.
• Shaikh SI, Nagarekha D, Hegade G, et al. Postoperative nausea and vomiting: A simple yet complex problem. Anesth Essays Res. 2016;10(3):388-96.
• Albuquerque AFM, Queiroz SIML, Germano AR, et al. Factors associated to post-operative nausea and vomiting following oral and maxillofacial surgery: a prospective study. Oral Maxillofac Surg. 2017;21(1):49-54.
• Silva AC, O’Ryan F, Poor DB. Postoperative nausea and vomiting (PONV) after orthognathic surgery: a retrospective study and literature review. J Oral Maxillofac Surg. 2006;64(9):1385-97.
• Carrol NV, Miederhoff P, Cox FM, et al. Postoperative nausea and vomiting after discharge from outpatient surgery centers. Anesth Analg. 1995; 80(5):903-9.
• Novosad S, Khan S, Bruce W, et al. Role of Obesity in Asthma Control, the Obesity-Asthma Phenotype. J Allergy. 2013;2013:538-642.
• Perrott DH, Yuen JP, Andresen RV, et al. Office-based ambulatory anesthesia: outcomes of clinical practice of oral and maxillofacial surgeons. J Oral Maxillofac Surg. 2003;61(9):983-95.
• Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg. 2006;102(6):1884-98.
• Phillips C, Brookes CD, Rich J, et al. Postoperative nausea and vomiting following orthognathic surgery. Int J Oral Maxillofac Surg. 2015;44(6):745-51.
• Jin Z, Gan TJ, Bergese SD. Prevention and Treatment of Postoperative Nausea and Vomiting (PONV): A Review of Current Recommendations and Emerging Therapies. Ther Clin Risk Manag. 2020;31(16):1305-17.
• Echeverria-Villalobos M, Fiorda-Diaz J, Uribe A, et al. Postoperative Nausea and Vomiting in Female Patients Undergoing Breast and Gynecological Surgery: A Narrative Review of Risk Factors and Prophylaxis. Front Med. 2022;1(9):909-82.
• Sinclair DR, Chung F, Mezei G. Can postoperative nausea and vomiting be predicted. Anesthesiology. 1999;91(1):109–18.
• Gan TJ, Belani KG, Bergese S, et al. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesth Analg. 2020;131(2):411-48.
• Gan TJ, Diemunsch P, Habib AS, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014;118(1):85-113.
• Cohen MM, Duncan PG, DeBoer DP, et al: The postoperative interview: Assessing risk factors for nausea and vomiting. Anesth Analg. 1994;78(1):7-16.
• Apfel CC, Greim CA, Haubitz I, et al. A risk score to predict the probability of postoperative vomiting in adults. Acta Anaesthesiol Scand. 1998;42(5):495–501.
• Apfel CC, Greim CA, Haubitz I, et al. The discriminating power of a risk score for postoperative vomiting in adults undergoing various types of surgery. Acta Anaesthesiol Scand. 1998;42(5):502–9.
• Smith CA, Ruth-Sahd L. Reducing the Incidence of Postoperative Nausea and Vomiting Begins With Risk Screening: An Evaluation of the Evidence. Journal of PeriAnesth Nurs. 2016;31(2):158-71.
• Hasegawa H, Abe A, Hayashi H, et al. Risk factors for postoperative nausea and vomiting after the removal of impacted third molars: a cross-sectional study. BMC Oral Health. 2021;21(1):1-5.
• Bakri MH, Ismail EA, Ali MS, et al. Behavioral and emotional effects of repeated general anesthesia in young children. Saudi J Anaesth. 2015;9(2):161-6.
• Cheong Y, Kang SS, Kim M, et al. Submental Intubation in Patients with Complex Maxillofacial Injuries. J Lifestyle Med. 2016;6(2):68-71.
• Alexander M, Krishnan B, Yuvraj V. Prophylactic antiemetics in oral and maxillofacial surgery: a requiem? J Oral Maxillofac Surg. 2009;67(9):1873-7.
• Tramèr MR. A rational approach to the control of postoperative nausea and vomiting: Evidence from systematic reviews: Part II. Recommendations for prevention and treatment, and research agenda. Acta Anaesthesiol Scand. 2001;45(1):14 –9.
• Andersen R, Krohg K. Pain as a major cause of postoperative nausea. Can Anaesth Soc J. 1976;23(4):366-9.