Orthognathic surgery: nasogastric tube responsable of the nausea and vomiting?

Introduction: Orthognathic surgery often requires intermaxillary fixation with wires or elastics. Nausea and vomiting are common (40–50%) despite of antiemetic drugs.

Target: Check if the nasogastric tube is effective in reducing the incidence of nausea and vomiting in orthognathic surgery during first 48 h.

Material and methods: We present a prospective observational study approved by Ethics Committee. Patients included are ones elected for orthognathic surgery. Exclusion criteria were contraindications to either drug or controlled hypotension. Patients received antiemetic prophylaxis with 4–8 mg dexamethasone and 1.25 mg droperidol. We randomly assigned patients into 2 groups depending on the placement of nasogastrict tube and intermittent aspiration (NG group) or not (NoNG group). After that, we supply 4 mg ondasetron each 8 h at post-operative care unit and at ward.

Results: Five-months sample consists on 29 patients: 12 patients NG group and 17 patients NoNG group. The groups are homogeneous in preoperative data as well as surgical and anesthetic technique used. The first 6 h nausea incidence at post-operative care unit is less at NoNG group (25% vs 50%, p = 0.19), the same as vomiting (12.5% vs 25%, p = 0.6). The need to administer ondansetron bolus at post-operative care unit is higher in NG group (83.3% vs 17.6%, p = 0.004).

Conclusions: Nasogastric tube with intermittent aspiration seems to increase nausea and vomiting incidence and intensity.

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Jan 21, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Orthognathic surgery: nasogastric tube responsable of the nausea and vomiting?
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