Bimaxillar Surgery, Penehyclidine, Postoperative Nausea and Vomiting
Conditions
Keywords
Penehyclidine, Postoperative nausea and vomiting, Bimaxillary surgery
Brief summary
Postoperative nausea and vomiting (PONV) are common complications after surgery. Patients undergoing orthognathic surgery are reported to have a high rate of PONV, especially those undergoing bimaxillary surgery. Activation of cholinergic system plays an important role in the development of PONV. Penehyclidine is an muscarinic antagonists which selectively block M1 and M3 receptors and is commonly used to decrease oral secretion. The purpose of this retrospective cohort study is to investigate whether use of penehyclidine is associated with a reduced risk of PONV in patients undergoing bimaxillary surgery.
Detailed description
Postoperative nausea and vomiting (PONV) are one of the most frequent complications after surgery, and are associated with patients' dissatisfaction after anesthesia and surgery. Orthognathic surgery is widely performed for the correction of dentofacial deformities. PONV is common after orthognathic surgery. Despite of improved anti-emetic prophylaxis, patients undergoing orthognathic surgery are reported to have a high incidence of PONV, especially those after bimaxillary surgery. It is known that activation of central cholinergic system plays an important role in the development of PONV. Muscarinic antagonists such as scopolamine can block muscarinic receptors in the cerebral cortex and produce anti-emetic effects. Penehyclidine is a new muscarinic antagonists which selectively block M1 and M3 receptors. It has fewer adverse effects compared with other anticholinergics. The purpose of this retrospective cohort study is to investigate whether use of penehyclidine is associated with a reduce risk of PONV in patients undergoing bimaxillary surgery.
Interventions
Penehyclidine hydrochloride was administered before anesthesia induction.
OTHERNo penehyclidine hydrochloride
Penehyclidine hydrochloride was not administered before anesthesia induction.
Sponsors
Peking University Hospital of Stomatology
Peking University First Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥16 years; * Underwent elective bimaxillary surgery under general anesthesia.
Exclusion criteria
* Age \<16 years; * Missing data.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative nausea and vomiting (PONV) within 48 hours after bimaxillary surgery. | Up to 48 hours after surgery. | Nausea was assessed by direct questioning. Vomiting was diagnosed when patients retched or expulsed intra-gastric contents. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative agitation after bimaxillary surgery. | Up to 8:00 am on the first day after surgery. | Postoperative agitation was diagnosed when a Richmond Agitation-Sedation Scale (scale ranges from -5 to +4, with higher scale indicating severe agitation) reached +2 or more at any time within 2 hours after extubation. |
| Postoperative pain after bimaxillary surgery. | Up to 2 days after surgery. | Postoperative pain was assessed with the Numeric Rating Scale (an 11-point scale where 0=no pain and 10=the worst pain). A score of 4 or more is defined a moderate-to-severe pain. |
| Daily prevalence of PONV. | Up to 48 hours after surgery. | Daily prevalence of PONV on the day of surgery, as well as the first and second day after surgery. |
| Length of stay in hospital after surgery. | Up to 30 days after surgery. | Length of stay in hospital after surgery. |
| In-hospital mortality after surgery. | Up to 30 days after surgery. | In-hospital mortality after surgery. |
| Postoperative complications during hospital stay after surgery. | Up to 30 days after surgery. | Postoperative complications were generally defined as new-onset medical events that were harmful for patients' recovery and required therapeutic intervention. |
Countries
China
Outcome results
None listed