Anesthesia/facial painPostdischarge Nausea and Vomiting Remains Frequent After Le Fort I Osteotomy Despite Implementation of a Multimodal Antiemetic Protocol Effective in Reducing Postoperative Nausea and Vomiting
Section snippets
Materials and Methods
A prospective, institutional review board–approved clinical trial (919.966.3113, University of North Carolina, Chapel Hill) with a retrospective comparison group was registered with ClinicalTrials.gov. (NCT01592708) This study showed a statistical decrease in postoperative nausea (PON) and postoperative vomiting (POV) experienced by patients undergoing Le Fort I osteotomy, with or without additional procedures, after the introduction of a multimodal antiemetic protocol. PDNV was studied in the
Results
Diaries were completed by 85% of patients in the intervention group (n = 79) and 75% of patients in the comparison group (n = 103). The total intervention (n = 93) and comparison (n = 137) groups were similar in gender (P = .29), race (P = .85), age (P = .75), proportion of patients with known risk factors for PONV (including female gender, nonsmoking status, history of PONV or motion sickness, and history of migraine headaches; P = .34), percentage undergoing bimaxillary surgery (60% in each
Discussion
The authors hypothesized that the prevalence of PDNV would be high after Le Fort I surgery and that the prevalence would be decreased by the antiemetic protocol. The prevalence of PDNV was indeed very high in this patient population. However, although this multimodal antiemetic protocol statistically decreased PON and POV,1 it had no statistical impact on PDNV. There was a trend toward slightly more PDN that lasted slightly longer in the intervention group, but a trend toward more PDV in the
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This research was funded by National Institutes of Health grant R01 DE 005215.
Conflict of Interest Disclosures: None of the authors reported any disclosures.