Rapolu Keerthi, Uppada Uday Kiran, Sinha Ramen, Subramanya Kumar A V S S
Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India.
Department of Anesthesia, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India.
Natl J Maxillofac Surg. 2022 May-Aug;13(2):283-288. doi: 10.4103/njms.NJMS_346_21. Epub 2022 Jul 15.
The objective is to evaluate the efficacy of prophylactic single intravenous dose of palonosetron in the management of postoperative nausea and vomiting (PONV) following oral and maxillofacial surgical interventions performed through an intraoral approach under general anesthesia (GA).
A prospective study was conducted on 100 subjects who underwent intraoral surgical procedures for the management of maxillofacial trauma, pathology, dentofacial anomalies, and deformities under GA. All subjects received a prophylactic single intravenous dose of 0.075 mg palonosetron along with premedication. Predisposing factors for PONV such as patient age, gender, Apfel risk score, history of motion sickness, smoking, type of procedure, and administration of postoperative opioids were taken into consideration. All the patients were monitored for PONV for the 1 24 h postoperatively (PO). First, at an interval of 30 min for 1 4 h and then at every 2 h interval for next 8 h followed by monitoring every 6 h interval till 24 h. Time and frequency of rescue medication were noted.
Seventy-nine percentage subjects did not have PONV. 15% subjects had a single episode of vomiting PO which could be attributed to multiple intra oral surgical sites performed as well as longer duration of exposure to anesthetic agents in addition to providing opioid analgesics for the management of postoperative pain. Only 6% subjects needed rescue antiemetic drug. Palonosetron did not show any significant changes in cardiac status and serum profile.
Palonosetron is effective in the management of PONV for maxillofacial surgical procedures performed through an intraoral approach under GA.
评估预防性单次静脉注射帕洛诺司琼对全身麻醉（GA）下经口入路进行口腔颌面外科手术后恶心呕吐（PONV）的治疗效果。
对100例在GA下接受口腔内手术治疗颌面创伤、病变、牙颌面畸形和畸形的患者进行前瞻性研究。所有受试者在术前用药时接受单次静脉注射0.075mg帕洛诺司琼。考虑了PONV的诱发因素，如患者年龄、性别、阿普费尔风险评分、晕动病史、吸烟、手术类型和术后阿片类药物的使用情况。所有患者在术后124小时（PO）内监测PONV。首先，在14小时内每隔30分钟监测一次，然后在接下来的8小时内每隔2小时监测一次，随后每隔6小时监测一次直至24小时。记录急救药物的时间和频率。
79%的受试者未发生PONV。15%的受试者术后出现单次呕吐，这可能归因于多个口腔内手术部位以及除了使用阿片类镇痛药治疗术后疼痛外，麻醉剂暴露时间较长。只有6%的受试者需要急救止吐药。帕洛诺司琼在心脏状态和血清指标方面未显示任何显著变化。
帕洛诺司琼对GA下经口入路进行的颌面外科手术中PONV的治疗有效。
