Nausea Clinical Trial
Official title:
Do Pharyngeal Packs During Orthognathic Surgery Reduce Postoperative Nausea and Vomiting. A Prospective Randomized Double Blind Clinical Trial.
The purpose of this study is to determine whether pharyngeal packs can reduce nausea and vomiting in patients undergoing orthognathic surgery.
Post-operative nausea and vomiting (PONV) is one of the most frequent and distressing
complications of anesthesia. Patients often rate that PONV is worse than postoperative pain.
PONV alone is one of the leading causes for delayed discharge and unpleasant experiments.
Although PONV is not always life-threatening, persistent cases can result in dehydration,
esophageal rupture, aspiration and potential death. The massive ingested blood and the
additional issue of an altered diet (full liquids) due to a short period of jaw
immobilization may be associated with a higher prevalence of PONV after orthognathic
surgeries.
Although most of antiemetic drugs can help prevent PONV, they cannot preclude vomiting
resulting from irritating gastrointestinal stimuli such as blood in the stomach. Pharyngeal
packs are thought to prevent the ingestion and aspiration of blood, cartilage and bone
fragments during oral and maxillofacial surgeries. Whether pharyngeal packs can reduce the
incidence of PONV is controversial. It is reported that pharyngeal packs are recommended for
the purpose of preventing PONV in nasal surgeries. However, some authors suggest that
pharyngeal packs have no impact on PONV or the prevalence of PONV is doubled during routine
nasal surgeries. However, the population size in these studies is relatively small and the
trials have significant methodological weakness. None of these trials totally addressed the
issue of the pharyngeal packs on the PONV following nasal surgeries. Moreover, these studies
include different types of nasal surgeries, not all of which can be assumed to have
equivalent bleeding potential.
Orthognathic surgeries performed maxillary and mandibular osteotomies and are assumed to
involve massive blood loss. Orofacial swelling and swallowing blood is common in the early
postoperative period after orthognathic surgeries. Whether pharyngeal packs can reduce the
swallowing blood and PONV is unknown. Thus, The objective of this study is to determine
whether pharyngeal packs can reduce nausea and vomiting in patients undergoing orthognathic
surgery.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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