Journal Article

Impact of general anesthesia on postoperative complications in orthognathic surgery: a retrospective comparison of total intravenous anesthesia versus volatile anesthesia

Yoshiro Sakaguchi, Reona Aijima, Ayako Takamori, Asana Kamohara, Atsushi Danjo, Daisuke Miura, Yoshio Yamashita

2024

Overview

Orthognathic surgery has a high incidence of postoperative nausea (PON) and vomiting (POV), delaying mobility initiation and postoperative recovery. Bleeding is another risk associated with this surgical procedure. We aimed to compare total intravenous anesthesia (TIVA) and volatile anesthesia in patients undergoing orthognathic surgery in terms of postoperative nausea and vomiting (PONV) incidence and hemodynamic changes. This retrospective study included 82 patients who underwent bilateral sagittal split ramus osteotomies at Saga University Hospital between April 2016 and April 2021. We compared the effects of TIVA and volatile anesthesia on PONV onset after surgery, acute postoperative hemodynamic changes (blood pressure and heart rate), and factors contributing to PONV. PON was significantly lower in the TIVA group than in the volatile anesthesia group. The total dose of fentanyl contributed to the onset of POV, while the onset of PON was associated with low volumes of fluid infusion and urine in the TIVA and volatile anesthesia groups, respectively. Furthermore, post-extubation hemodynamic change was significantly smaller in the TIVA group than in the volatile anesthesia group. Therefore, TIVA could have a reduced risk of PONV and hemodynamic changes in patients undergoing orthognathic surgery. Employing TIVA could mitigate perioperative complications and enhance patient safety.

• Publisher: Springer Science and Business Media LLC,Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 692/308 / 692/499 / Adult / Anesthesia / Anesthesia, General - adverse effects / Anesthesia, General - methods / Anesthesia, Inhalation - adverse effects / Anesthesia, Inhalation - methods / Anesthesia, Intravenous - adverse effects / Anesthesia, Intravenous - methods / Anesthetics, Intravenous - administration & dosage / Anesthetics, Intravenous - adverse effects / Blood pressure / Complications / Female / Fentanyl / Fentanyl - administration & dosage / Fentanyl - adverse effects / Heart rate / Hemodynamics / Hemodynamics - drug effects / Humanities and Social Sciences / Humans / Intravenous administration / Male / Medicine / multidisciplinary / Nausea / Orthognathic Surgery - methods / Orthognathic Surgical Procedures - adverse effects / Orthognathic Surgical Procedures - methods / Osteotomy, Sagittal Split Ramus - adverse effects / Osteotomy, Sagittal Split Ramus - methods / Patients / Postoperative / Postoperative Complications - epidemiology / Postoperative Complications - etiology / Postoperative Complications - prevention & control / Postoperative Nausea and Vomiting - epidemiology / Postoperative Nausea and Vomiting - etiology / Q / R / Retrospective Studies / Science / Science (multidisciplinary) / Surgery / Vomiting / Young Adult