Haapanen, A.

Snäll, J.

Thoren, H.

International Journal of Oral and Maxillofacial Surgery

English

A. Haapanen

H. Thorén

J. Snäll

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Postoperative nausea and vomiting in facial fracture patients: a randomized and controlled trial on the effect of dexamethasone

Helsingin yliopiston digitaalinen arkisto

1228 Letters to the EditorBK, Tramèr MR, Society for AmbulatoryAnesthesia. Consensus guidelines for themanagement of postoperative nausea andvomiting. Anesth Analg 2014;118:85–113.https://doi.org/10.1016/j.ijom.2018.04.019Postoperative nausea and vomiting infacial fracture patients: a randomizedand controlled trial on the effect ofdexamethasoneWe thank our colleagues for their interestin our article and for their valuable com-ments.The difference in intraoperative analge-sic consumption was likely small. Therewas no statistically significant differencein sex (P = 0.459), age (P = 0.700), orduration of anesthesia (P = 0.363) be-tween the study groups. Moreover, inclu-sion criteria for the present study were thatpatients were generally healthy and under-went surgical treatment of ‘simple’ man-dibular, zygomatic, or orbital fracturesthat were managed with standardized sur-gical methods. No severe, comminuted, ormultiple facial fractures requiring exten-sive surgery were included. In addition,approaches were exclusively local, i.e.,extraoral approaches in mandibular frac-tures, and no coronal approaches wereused in zygomatic fractures.Intraoperative pain control was stan-dardized as follows: Each patient received0.1–0.2 mg fentanyl during induction ofanesthesia. During surgery, a bolus offentanyl (0.05–0.1 mg) was given if thepatient’s heart rate and/or systolic bloodpressure increased by 15%.Ondansetron was not given routinely toall patients. It was used as a rescue andadministered immediately when patientsneeded it.Of the 119 patients included in thestudy, 96 received opioids after surgery:45 were in the study group and 51 were inthe control group; this difference was notstatistically significant (P = 0.2269).We hope that this response answersyour questions satisfactorily.FundingNone.Competing interestsThe authors have declared that no con-flicts of interest exist.Ethical approvalThe Research Ethics Board of theDepartment of Surgery and the InternalReview Board of the Division of Muscu-loskeletal Surgery, Helsinki UniversityCentral Hospital, Finland, approved thestudy (Dno 33/E6/06) in accordance withthe Declaration of Helsinki 1975 andamendments thereafter.Patient consentInformed written consent was obtainedfrom all patients.A. Haapanen*Department of Oral and MaxillofacialDiseases, University of Helsinki andHelsinki University Hospital, Helsinki,FinlandH. ThorénDepartment of Oral and MaxillofacialSurgery, Institute of Dentistry, Universityof Turku, Finland and Department of Oraland Maxillofacial Diseases, TurkuUniversity Hospital, FinlandJ. SnällDepartment of Oral and MaxillofacialDiseases, University of Helsinki andHelsinki University Hospital, Helsinki,Finland*Address: Aleksi Haapanen, Departmentof Oral and Maxillofacial Diseases,Helsinki University Hospital, 00029HUH, Finland. Tel: +358 40 7251598E-mail address: aleksi.haapanen@hel-sinki.fi (A. Haapanen)https://doi.org/10.1016/j.ijom.2018.04.020

Postoperative nausea and vomiting in facial fracture patients : a randomized and controlled trial on the effect of dexamethasone

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Postoperative nausea and vomiting in facial fracture patients : a randomized and controlled trial on the effect of dexamethasone

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Helsingin yliopiston digitaalinen arkisto