Control of Postoperative Nausea and Vomiting in Oral and Maxillofacial Surgery Patients with Isopropyl Alcohol: A Prospective Randomized Clinical Trial

J Maxillofac Oral Surg. 2018 Dec;17(4):576-581. doi: 10.1007/s12663-018-1094-3. Epub 2018 Feb 21.

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.

Keywords: Isopropyl alcohol; Maxillofacial surgery; Nausea and vomiting after surgery; PONV.