Our Summary

This research paper investigates the factors that might increase the risk of postoperative nausea and vomiting (PONV) - that’s the sick feeling and vomiting that can happen after you’ve been put under general anesthesia for a surgery. The researchers looked specifically at patients who were under total intravenous anesthesia (TIVA, a type of anesthesia delivered through an IV) for dental or oral surgery.

They found that younger patients and female patients were more likely to experience PONV. Also, patients who had specific types of oral surgeries - sagittal split ramus osteotomy (SSRO, a type of jaw surgery) and bimaxillary osteotomy (a surgery that corrects facial deformities by repositioning the upper and lower jaws) - were more likely to experience PONV than patients who had other types of surgeries.

Interestingly, they also found that PONV was more likely to occur 2-24 hours after the surgery than right after the surgery.

These findings suggest that, even though TIVA is known to reduce the risk of PONV, more strategies to prevent PONV are needed, especially for patients undergoing these specific types of surgeries.

FAQs

  1. What factors increase the risk of postoperative nausea and vomiting (PONV) after dental or oral surgery?
  2. Are certain patients more likely to experience PONV after oral surgery?
  3. What strategies can be used to prevent PONV after oral surgery, especially for high-risk patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about oral surgery is to follow all pre-operative instructions carefully, including fasting before the surgery and avoiding certain medications that can increase the risk of complications. It’s also important to discuss any concerns or fears with the surgeon beforehand so they can address them and ensure you have a comfortable experience. Additionally, make sure to follow all post-operative instructions for a smooth recovery and to minimize the risk of complications like PONV.

Suitable For

In general, patients who undergo oral surgery are typically recommended for oral surgery. This includes patients who need to have impacted wisdom teeth removed, patients with severe dental infections, patients who need dental implants, patients with jaw misalignment or other structural issues, and patients who need to have biopsies or other oral surgeries for diagnostic purposes.

Additionally, patients who have underlying medical conditions that may complicate dental procedures, such as bleeding disorders, heart conditions, or compromised immune systems, may also be recommended for oral surgery. Patients who have had previous oral surgeries that have resulted in complications or who have a history of difficulty with dental procedures may also be candidates for oral surgery.

Ultimately, the decision to undergo oral surgery is made on a case-by-case basis by a dental or oral surgeon, taking into account the patient’s individual needs, medical history, and the specific procedure being recommended.

Timeline

Before oral surgery:

  • Consultation with an oral surgeon to discuss the procedure and potential risks
  • Pre-operative evaluation to assess the patient’s medical history and current health status
  • Instructions to follow before the surgery, such as fasting for a certain period of time
  • Administration of anesthesia before the surgery begins

After oral surgery:

  • Recovery in a post-anesthesia care unit (PACU) immediately after the surgery
  • Monitoring of vital signs and pain levels by healthcare providers
  • Instructions for post-operative care, such as taking prescribed medications and maintaining oral hygiene
  • Follow-up appointments to monitor healing progress and address any concerns or complications

Overall, the timeline for a patient undergoing oral surgery involves thorough preparation before the procedure, careful monitoring and management of post-operative symptoms, and ongoing follow-up care to ensure a successful recovery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with oral surgery?
  2. How long will the recovery process take and what can I expect during this time?
  3. Are there any specific dietary restrictions or guidelines I should follow before and after the surgery?
  4. What type of anesthesia will be used during the surgery and what are the potential side effects?
  5. How can I best manage any pain or discomfort after the surgery?
  6. Are there any specific instructions I should follow to ensure proper healing and minimize the risk of infection?
  7. What should I do if I experience any unexpected symptoms or complications after the surgery?
  8. Will I need to make any follow-up appointments after the surgery?
  9. Are there any specific activities or habits I should avoid during the recovery period?
  10. What can I do to help reduce the risk of postoperative nausea and vomiting based on the findings of this research study?

Reference

Authors: Ishikawa E, Iwamoto R, Hojo T, Teshirogi T, Hashimoto K, Shibuya M, Kimura Y, Fujisawa T. Journal: Anesth Prog. 2022 Apr 1;69(1):18-23. doi: 10.2344/anpr-68-03-12. PMID: 35377932