Abstract
Purpose
The present study was undertaken to evaluate the effectiveness of inhaled 70% isopropyl alcohol (IPA) in controlling postoperative nausea and vomiting (PONV) in oral and maxillofacial surgery patients undergoing surgery under general anesthesia (GA).
Materials and Methods
This was a prospective, randomized, case-controlled study done on 208 maxillofacial surgery patients operated under GA. Patient’s demographic data, APFEL score for risk of PONV, duration of surgery and duration of anesthesia were recorded preoperatively. The test arm of the study received inhalation of 70% IPA every half an hour in the postoperative period for 8 h along with ondansetron 4 mg i.v. every 6 h. The control arm received only ondansetron 4 mg i.v. every 6 h. Both the groups followed the same preoperative and postoperative instruction and drug protocol except the test drug. PONV was recorded using the simplified PONV intensity score and VAS. The scores were analyzed with Mann–Whitney test with < 0.05 considered significant.
Results
The groups were similar with regard to age (p = 0.083), BMI (p = 0.1.00), sex (p = 0.379), type of surgery (p = 0.504), duration of anesthesia (p = 0.621), duration of surgery (p = 0.515) and APFEL score (p = 0.687). IPA inhalation group achieved significantly better simplified PONV scores and VAS scores at 4 h (p = 0.000), 6 h (p = 0.000) and 8 h (p = 0.000). PONV control at 2 h was similar to the control group.
Conclusion
Inhalation of 70% IPA every half an hour was associated with significant PONV control in maxillofacial surgery patients undergoing surgery under GA.
Similar content being viewed by others
References
Apfel CC, Läärä E, Koivuranta M, Greim CA, Roewer N (1999) A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology 91(3):693–700
Koivuranta M, Läärä E, Snåre L, Alahuhta S (1997) A survey of postoperative nausea and vomiting. Anaesthesia 52(5):443–449
White PF, Watcha MF (1999) Postoperative nausea and vomiting: prophylaxis versus treatment. Anesth Analg 89(6):1337–1339
Silva AC, O’Ryan F, Poor DB (2006) Postoperative nausea and vomiting (PONV) after orthognathic surgery: a retrospective study and literature review. J Oral Maxillofac Surg 64(9):1385–1397
Dicus C, Arbon J, Turey T, Blakey G, Philips C (2011) Evaluation of post-operative and post-discharge nausea and vomiting in orthognathic surgery patients. J Oral Maxillofac Surg 69(9 Suppl):e25
Kovac AL (2000) Prevention and treatment of postoperative nausea and vomiting. Drugs 59(2):213–243
Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N, IMPACT Investigators (2004) A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. New Engl J Med 350(24):2441–2451
Kovac AL, O’Connor TA, Pearman MH et al (1999) Efficacy of repeat intravenous dosing of ondansetron in controlling postoperative nausea and vomiting: a randomized, double-blind, placebo-controlled multicenter trial. J Clin Anesth 11(6):453–459
Gan TJ, Meyer TA, Apfel CC et al (2007) Society for ambulatory anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg 105(6):1615–1628
Cotton JW, Rowell LR, Hood RR, Pellegrini JE (2007) A comparative analysis of isopropyl alcohol and ondansetron in the treatment of postoperative nausea and vomiting from the hospital setting to the home. AANA J 75(1):21–26
Anderson LA, Gross JB (2004) Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postoperative nausea. J Perianesth Nurs 19(1):29–35
Winston AW, Rinehart RS, Riley GP, Vacchiano CA, Pellegrini JE (2003) Comparison of inhaled isopropyl alcohol and intravenous ondansetron for treatment of postoperative nausea. AANA J 71(2):127–132
Myles PS, Wengritzky R (2012) Simplified postoperative nausea and vomiting impact scale for audit and post-discharge review. Br J Anaesth 108(3):423–429
Pellegrini J, DeLoge J, Bennett J, Kelly J (2009) Comparison of inhalation of isopropyl alcohol vs promethazine in the treatment of postoperative nausea and vomiting (PONV) in patients identified as at high risk for developing PONV. AANA J 77(4):293–299
Merritt BA, Okyere CP, Jasinski DM (2002) Isopropyl alcohol inhalation: alternative treatment of postoperative nausea and vomiting. Nurs Res 51(2):125–128
Langevin P, Brown M (1997) A simple, innocuous and inexpensive treatment for postoperative nausea and vomiting. Anesth Analg 84(Suppl):S16
Wang SM, Hofstadter MB, Kain ZN (1999) An alternative method to alleviate postoperative nausea and vomiting in children. J Clin Anesth 11(3):231–234
Radford KD, Fuller TN, Bushy B, Daniel C, Pellegrini JE (2011) Prophylactic isopropyl alcohol inhalation and intravenous ondansetron versus ondansetron alone in the prevention of postoperative nausea and vomiting in high risk patients. AANA J 79(4 Suppl):s69–s74
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Institutional ethical clearance was obtained for the present study.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Verma, D.K., Bansal, S., Sharma, P. et al. Control of Postoperative Nausea and Vomiting in Oral and Maxillofacial Surgery Patients with Isopropyl Alcohol: A Prospective Randomized Clinical Trial. J. Maxillofac. Oral Surg. 17, 576–581 (2018). https://doi.org/10.1007/s12663-018-1094-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12663-018-1094-3