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.
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.
Study Type
OBSERVATIONAL
Enrollment
243
Penehyclidine hydrochloride was administered before anesthesia induction.
Penehyclidine hydrochloride was not administered before anesthesia induction.
Peking University Hospital of Stomatology
Beijing, Beijing Municipality, China
Peking University Hospital of Stomatology
Beijing, Haidian, China
Postoperative nausea and vomiting (PONV) within 48 hours after bimaxillary surgery.
Nausea was assessed by direct questioning. Vomiting was diagnosed when patients retched or expulsed intra-gastric contents.
Time frame: Up to 48 hours after surgery.
Daily prevalence of PONV.
Daily prevalence of PONV on the day of surgery, as well as the first and second day after surgery.
Time frame: Up to 48 hours after surgery.
Postoperative agitation after bimaxillary 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.
Time frame: Up to 8:00 am on the first day after surgery.
Postoperative pain after bimaxillary 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.
Time frame: Up to 2 days after surgery.
Postoperative complications during hospital stay after surgery.
Postoperative complications were generally defined as new-onset medical events that were harmful for patients' recovery and required therapeutic intervention.
Time frame: Up to 30 days after surgery.
Length of stay in hospital after surgery.
Length of stay in hospital after surgery.
Time frame: Up to 30 days after surgery.
In-hospital mortality after surgery.
In-hospital mortality after surgery.
Time frame: Up to 30 days after surgery.
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