Verma Dinesh Kumar, Bansal Shallu, Sharma Parveen, Sundararaman Prabhu
1Department of Oral and Maxillofacial Surgery, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan 335001 India.
Director Academic and Research, Tantia University, Sri Ganganagar, Rajasthan 335001 India.
J Maxillofac Oral Surg. 2018 Dec;17(4):576-581. doi: 10.1007/s12663-018-1094-3. Epub 2018 Feb 21.
The present study was undertaken to evaluate the effectiveness of inhaled 70% isopropyl alcohol (IPA) in controlling postoperative nausea and vomiting (PONV) in oral and maxillofacial surgery patients undergoing surgery under general anesthesia (GA).
This was a prospective, randomized, case-controlled study done on 208 maxillofacial surgery patients operated under GA. Patient's demographic data, APFEL score for risk of PONV, duration of surgery and duration of anesthesia were recorded preoperatively. The test arm of the study received inhalation of 70% IPA every half an hour in the postoperative period for 8 h along with ondansetron 4 mg i.v. every 6 h. The control arm received only ondansetron 4 mg i.v. every 6 h. Both the groups followed the same preoperative and postoperative instruction and drug protocol except the test drug. PONV was recorded using the simplified PONV intensity score and VAS. The scores were analyzed with Mann-Whitney test with < 0.05 considered significant.
The groups were similar with regard to age ( = 0.083), BMI ( = 0.1.00), sex ( = 0.379), type of surgery ( = 0.504), duration of anesthesia ( = 0.621), duration of surgery ( = 0.515) and APFEL score ( = 0.687). IPA inhalation group achieved significantly better simplified PONV scores and VAS scores at 4 h ( = 0.000), 6 h ( = 0.000) and 8 h ( = 0.000). PONV control at 2 h was similar to the control group.
Inhalation of 70% IPA every half an hour was associated with significant PONV control in maxillofacial surgery patients undergoing surgery under GA.
本研究旨在评估吸入70%异丙醇（IPA）对全身麻醉（GA）下接受口腔颌面外科手术患者术后恶心呕吐（PONV）的控制效果。
这是一项对208例在GA下接受手术的颌面外科患者进行的前瞻性、随机、病例对照研究。术前记录患者的人口统计学数据、PONV风险的APFEL评分、手术时间和麻醉时间。研究的试验组在术后8小时内每半小时吸入一次70% IPA，同时每6小时静脉注射4毫克昂丹司琼。对照组仅每6小时静脉注射4毫克昂丹司琼。除试验药物外，两组遵循相同的术前和术后指导及药物方案。使用简化的PONV强度评分和视觉模拟量表（VAS）记录PONV情况。采用Mann-Whitney检验分析评分，P<0.05被认为具有统计学意义。
两组在年龄（P = 0.083）、体重指数（P = 0.100）、性别（P = 0.379）、手术类型（P = 0.504）、麻醉时间（P = 0.621）、手术时间（P = 0.515）和APFEL评分（P = 0.687）方面相似。IPA吸入组在术后4小时（P = 0.000）、6小时（P = 0.000）和8小时（P = 0.000）时，简化的PONV评分和VAS评分显著更好。2小时时的PONV控制情况与对照组相似。
对于在GA下接受手术的颌面外科患者，每半小时吸入一次70% IPA与显著控制PONV相关。
