Nakamura Tina, Ogata Fumika, Hoshijima Hiroshi, Nagasaka Hiroshi, Doi Katsushi, Mieda Tsutomu
Assistant Professor, Department of Anesthesiology, Saitama Medical University Hospital, Moroyamacho Irumagun, Japan.
Associate Professor, Department of Anesthesiology, Saitama Medical University Hospital, Moroyamacho Irumagun, Japan; Associate Professor, Division of Dento-Oral Anesthesiology, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.
J Oral Maxillofac Surg. 2025 Mar;83(3):279-285. doi: 10.1016/j.joms.2024.11.012. Epub 2024 Nov 30.
Whether postoperative nausea and vomiting (PONV) contributes to increased postoperative pain (POP) remains unclear, although POP is reported to cause PONV.
This study aimed to determine whether PONV following minor oral and maxillofacial surgery (OMS) under general anesthesia increases POP.
STUDY DESIGN, SETTING, SAMPLE: The researchers implemented a retrospective cohort study. Patients who presented to Saitama Medical University Hospital between January 2021 and August 2022 and who required minor OMS under general anesthesia were identified from a review of electronic records. The inclusion criteria were patients aged between 16 and 65 years and nasal intubation via inhalational or propofol-based total intravenous general anesthesia. The exclusion criterion was patients who had diseases affecting POP or PONV.
The primary predictor variable was the occurrence of PONV (yes/no) at 2 hours postoperatively.
The main outcome variable was POP measured on a 100 mm visual analog scale (VAS) at 2 hours postoperatively. The secondary outcome was the timing of POP, which was measured at 6 hours.
Covariates included patient-related factors (age, body mass index, American Society of Anesthesiologists Physical Status, smoking status, and history of PONV or motion sickness), anesthesia-related factors (intraoperative analgesics, intraoperative antiemetics, duration of anesthesia, and anesthesia type), and surgery-related factors (surgery type and duration of surgery).
Analyses were used for ordinal, categorical, and continuous variables. The POP VAS values were compared between each measurement time with repeated-measures analysis of variance. A P value < .05 indicated statistical significance.
The sample included 148 patients with a mean age of 40 ± 16.5 years, 66 (44.6%) of whom were male. The incidence of PONV was 31 (20.9%) at 0 to 2 hours, 7 (4.7%) at 2 to 6 hours, and 0 (0%) at 6 to 24 hours. POP VAS scores were significantly higher in the PONV group than in the non-PONV group at 2 hours. The mean VAS score at 2 hours was 40.5 ± 29.2 (PONV group) versus 29.8 ± 23.7 (non-PONV group) (P = .03); the VAS score at 6 hours was 41.0 ± 29.4 (PONV group) compared with 25.4 ± 26.4 (non-PONV group) (P = .13).
Our present study revealed that PONV is associated with increased POP in patients undergoing minor OMS under general anesthesia.
尽管据报道术后疼痛（POP）会导致术后恶心呕吐（PONV），但PONV是否会加重POP仍不清楚。
本研究旨在确定全身麻醉下进行的小型口腔颌面外科手术（OMS）后发生的PONV是否会加重POP。
研究设计、地点、样本：研究人员开展了一项回顾性队列研究。通过查阅电子病历，确定了2021年1月至2022年8月期间在埼玉医科大学医院就诊且需要在全身麻醉下进行小型OMS的患者。纳入标准为年龄在16至65岁之间且通过吸入或丙泊酚全静脉全身麻醉进行鼻腔插管的患者。排除标准为患有影响POP或PONV疾病的患者。
主要预测变量是术后2小时PONV的发生情况（是/否）。
主要结局变量是术后2小时用100毫米视觉模拟量表（VAS）测量的POP。次要结局是在6小时测量的POP发生时间。
协变量包括患者相关因素（年龄、体重指数、美国麻醉医师协会身体状况、吸烟状况以及PONV或晕动病史）、麻醉相关因素（术中镇痛药、术中止吐药、麻醉持续时间和麻醉类型）以及手术相关因素（手术类型和手术持续时间）。
分析用于有序、分类和连续变量。通过重复测量方差分析比较每个测量时间的POP VAS值。P值<0.05表示具有统计学意义。
样本包括148例患者，平均年龄为40±16.5岁，其中66例（44.6%）为男性。PONV的发生率在0至2小时为31例（20.9%），2至6小时为7例（4.7%），6至24小时为0例（0%）。术后2小时，PONV组的POP VAS评分显著高于非PONV组。2小时时的平均VAS评分为40.5±29.2（PONV组），而对照组为29.8±23.7（非PONV组）（P = 0.03）；6小时时的VAS评分为41.0±29.4（PONV组），而对照组为25.4±26.4（非PONV组）（P = 0.13）。
我们目前的研究表明，在全身麻醉下进行小型OMS的患者中，PONV与POP增加有关。
