Unerwartete Blutungskomplikationen im Zusammenhang mit Celecoxib

Enhanced recovery after orthognathic surgery: a retrospective comparison study of 56 patients

Enhanced Recovery After Surgery (ERAS) protocols have been demonstrated to expedite recovery and decrease hospital stay from multiple surgical specialties. This study sought to determine how an ERAS protocol would improve patient outcomes with regards to inpatient postoperative nausea, vomiting, and pain scores following orthognathic surgeries. This was a retrospective study comparing patients who underwent orthognathic surgery with and without an ERAS protocol. The primary measurables included opioid consumption, antiemetic medical consumption, nausea and vomiting incidences, and pain scores between the two groups during their hospital stays. A total of 56 patients were retrospectively analysed comparing ERAS protocol to non-ERAS protocol. The maximum pain score of the ERAS group was 5.50 out of 10 compared to the control group of 7.50 out of 10 (p<0.001). Morphine equivalent consumption during their time in the ward was statistically significant (51.4 mg control versus 9.4 mg ERAS group). ERAS protocol is safe and effective for decreasing postoperative pain and nausea. The ERAS protocol is not only applicable for orthognathic surgery but should be highly considered for other maxillofacial surgeries.

Management of postoperative nausea and vomiting in the context of an Enhanced Recovery after Surgery program

The concept of Enhanced Recovery after Surgery (ERAS) emerged at the turn of the millennium and quickly gained footing worldwide leading to the establishment of institutional ERAS protocols and subspecialty guidelines. While the use of postoperative nausea and vomiting (PONV) prophylaxis predates ERAS by a significant extent, the emergence of ERAS amplified the importance of antiemetic prophylaxis in perioperative care and drew attention to the truly multifactorial nature of postoperative gastrointestinal dysfunction. The following discussion will review key paradigms behind PONV prophylaxis and ERAS, highlight the interrelationship between these two endeavors, and then explore subspecialty ERAS guidelines that uniquely influence PONV prophylaxis. Attention will center on the ERAS Society guidelines (ESGs) as the primary representative of current ERAS practice, though many deviations from the guidelines exist within the literature and institutional practices.