Influencing factors of postoperative nausea and vomiting in orthognathic surgery patients: a meta-analysis

doi:10.19438/j.cjoms.2025.04.014

Abstract

Abstract: PURPOSE: To explore the influencing factors of postoperative nausea and vomiting(PONV) in orthognathic patients. METHODS: CNKI, Wanfang Database, Weipu.com, China Biomedical Database, PubMed, Web of Science, Cochrane Library, Embase and SpringerLink databases were searched to find relevant studies on the analysis of PONV influencing factors in orthognathus patients. The data were analyzed by RevMan5.3 software, the results of heterogeneity test were analyzed by fixed effects model or random effects model, and sensitivity analysis and publication bias evaluation were also conducted. RESULTS: A total of 7 literatures were included, with a total of 2280 subjects. The combined OR values of four factors were significant. The results showed gender [OR=1.62, 95%CI(1.12,2.33)], type of surgery [OR=1.77, 95%CI(1.41,2.22)], postoperative opioid use [OR=1.99, 95%CI(1.19,3.33)], PONV history [OR=2.98, 95%CI(1.66,5.35)] was the influencing factor of PONV in orthognathic patients. CONCLUSIONS: Female, bimaxillary orthognathic surgery, postoperative opioid use, and history of PONV were risk factors for orthognathic patients.

Key words: Orthognathic surgery, PONV, Influencing factors, Meta analysis

CLC Number:

R782.2

Jiang Meiping, Wang Zengxiang, Wu Ying, Li Ting, Huang Qian. Influencing factors of postoperative nausea and vomiting in orthognathic surgery patients: a meta-analysis[J]. China Journal of Oral and Maxillofacial Surgery, 2025, 23(4): 401-405.

References

[1] 李运峰, 祝颂松. 数字化技术在牙颌面畸形诊疗中的应用[J]. 口腔疾病防治, 2019, 27(2): 74-82.
Li YF, Zhu SS.Application of digital technology in diagnosis and treatment of dentofacial deformities[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2019, 27(2): 74-82.
[2] Ghosh S, Rai KK, Shivakumar HR, et al.Incidence and risk factors for postoperative nausea and vomiting in orthognathic surgery: a 10-year retrospective study[J]. J Korean Assoc Oral Maxillofac Surg, 2020, 46(2): 116-124.
[3] Silva AC, O Ryan F, Poor DB. Postoperative nausea and vomiting (PONV) after orthognathic surgery: a retrospective study and literature review[J]. J Oral Maxillofac Surg, 2006, 64(9): 1385-1397.
[4] Weibel S, Pace NL, Schaefer MS, et al.Drugs for preventing postoperative nausea and vomiting in adults after general anesthesia: an abridged Cochrane network meta-analysis[J]. J Evid Based Med, 2021, 14(3): 188-197.
[5] 曾梦婷, 何虹, 刘淑华, 等. 术后恶心呕吐预测模型的研究进展[J]. 护理研究, 2023, 37(20): 3701-3704.
Zeng MT, He H, Liu SH, et al.Research progress of prediction models for postoperative nausea and vomiting[J]. Chinese Nursing Research, 2023, 37(20): 3701-3704.
[6] 曹晖, 陈亚进, 顾小萍, 等. 中国加速康复外科临床实践指南(2021版)[J]. 中国实用外科杂志, 2021, 41(9): 961-992.
Cao H, Chen YJ, Gu XP, et al.Clinical practice guidelines for enhanced recovery after surgery in China(2021 edition)[J]. Chinese Journal of Practical Surgery, 2021, 41(9): 961-992.
[7] 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四:观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
Zeng XT, Liu H, Chen X, et al.Meta-analysis series Ⅳ: quality assessment tools for observational studies[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2012, 4(4): 297-299.
[8] 蒋美平, 王慧群, 张利漫, 等. 中国HIV/AIDS患者抑郁影响因素的Meta分析[J]. 现代预防医学, 2022,49(1):146-151.
Jiang MP, Wang HQ, Zhang LM, et al.Influencing factors of depression in Chinese HIV/AIDS patients: a meta-analysis[J]. Modern Preventive Medicine, 2022, 49(1): 146-151.
[9] Pourtaheri N, Peck C J, Maniskas S, et al.A comprehensive single-center analysis of postoperative nausea and vomiting following orthognathic surgery[J]. J Craniofac Surg, 2022, 33(2): 584-587.
[10] Ishikawa E, Iwamoto R, Hojo T, et al.Cross-sectional study of PONV risk factors for oral surgery after intubated general anesthesia with total intravenous anesthesia[J]. Anesth Prog, 2022, 69(1): 18-23.
[11] Yasli SO, Canpolat DG, Dogruel F, et al.Is postoperative pain associated with nausea and vomiting following orthognathic surgery?[J]. J Oral Maxillofac Surg, 2024, 82(3): 279-287.
[12] Phillips C, Brookes CD, Rich J, et al.Postoperative nausea and vomiting following orthognathic surgery[J]. Int J Oral Maxillofac Surg, 2015, 44(6): 745-751.
[13] Ishikawa E, Hojo T, Shibuya M, et al.Risk factors for postoperative nausea and vomiting in patients of orthognathic surgery according to the initial onset time: a cross-sectional study[J]. J Dent Anesth Pain Med, 2023, 23(1): 29-37.
[14] Zou L, Miao S, Wang L, et al.Effects of menstrual cycle on nausea and vomiting after general anesthesia[J]. J Anesth, 2020, 34(4): 519-526.
[15] Zhang N, Feng D, Wu W, et al.Influence of higher body mass index on postoperative nausea and vomiting in patients following thoracic surgery for lung cancer: a propensity score-matched cohort study[J]. Sci Rep, 2024, 14(1): 13873.
[16] Grape S, Usmanova I, Kirkham KR, et al.Intravenous dexamethasone for prophylaxis of postoperative nausea and vomiting after administration of long‐acting neuraxial opioids: a systematic review and meta‐analysis[J]. Anaesthesia, 2018,73(4): 480-489.
[17] McNicol E, Horowicz-Mehler N, Fisk RA, et al. Management of opioid side effects in cancer-related and chronic noncancer pain: a systematic review[J]. J Pain, 2003, 4(5): 231-256.
[18] Apfel CC, Turan A, Souza K, et al.Intravenous acetaminophen reduces postoperative nausea and vomiting: a systematic review and meta-analysis[J]. Pain, 2013, 154(5): 677-689.
[19] Gan TJ, Meyer TA, Apfel CC, et al.Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting[J]. Anesth Analg, 2007, 105(6): 1615-1628.
[20] Aydil BA, Akbas M, Ayhan M, et al.Retrospective examination of complications observed in orthognatic surgical surgery in 85 patients[J]. Ulus Travma Acil Cerrahi Derg, 2022, 28(5): 698-702.
[21] Faro TF, de Oliveira E Silva ED, Campos GJ, et al. Effects of throat packs during orthognathic surgery: a double-blind randomized controlled clinical trial[J]. Int J Oral Maxillofac Surg, 2021, 50(3): 349-355.
[22] Vural Ç, Yurttutan ME, Sancak KT, et al.Effect of chlorhexidine/benzydamine soaked pharyngeal packing on throat pain and postoperative nausea & vomiting in orthognathic surgery[J]. J Craniomaxillofac Surg, 2019, 47(12): 1861-1867.
[23] Oliveira De Jesus A, Lacerda De Toledo G, Marques De Oliveira Chiavaioli G, et al. Efficacy of gastric aspiration to reduce postoperative vomiting after orthognathic surgery: double-blind randomised clinical trial[J]. Br J Oral Maxillofac Surg, 2022, 60(4): 493-498.
[24] Wang J, Zhang Z.Gastric negative pressure suction method reduces the incidence of PONV after orthognathic surgery[J]. Front Surg, 2022, 9: 882726.
[25] Schmitt ARM, Ritto FG, de Azevedo JGRL, et al. Efficacy of gastric aspiration in reducing postoperative nausea and vomiting after orthognathic surgery: a double-blind prospective study[J]. J Oral Maxillofac Surg, 2017, 75(4): 701-708.
[26] Gao PF, Zhao L, Li SY, et al.Prevention of postoperative nausea and vomiting after orthognathic surgery: a scoping review[J]. BMC Anesthesiol, 2024, 24(1): 121-129.
[27] Grillo R, Borba AM, Brozoski MA, et al.Postoperative nausea and vomiting in orthognathic surgery: systematic review and meta-analysis[J]. Oral Maxillofac Surg, 2024, 28(3): 1019-1028.
[28] Bar AK, Werkmeister R, Dort JC, et al.Perioperative care in orthognathic surgery-a systematic review and meta-analysis for enhanced recovery after surgery[J]. J Craniomaxillofac Surg, 2024, 52(11): 1244-1258.