{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:10:37Z","timestamp":1791839437541,"version":"4.3.4"},"reference-count":46,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3]]},"abstract":"\n Objective<\/jats:title>\n This study aimed to evaluate the incidence of early (up to 2 h) and late (2\u201324 h) postoperative nausea and vomiting (PONV) and hypotension in patients who underwent general anesthesia for orthognathic surgery using propofol or remimazolam along with remifentanil.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective chart review included healthy adult patients under the age of 60 who underwent orthognathic surgery using propofol (P group) or remimazolam (R group) from January 2021 to March 2022. Records were reviewed to gather PONV and intraoperative hypotension data as well as patient characteristics and other variables.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Early PONV was significantly lower in the P group vs the R group (9.5% vs 34.1%, respectively;\n P<\/jats:italic>\n = .002), although the difference in late PONV was insignificant (36.9% vs 51.2%, respectively;\n P<\/jats:italic>\n = .13). A higher incidence of intraoperative hypotension was noted in the P group (22.6%) vs the R group (2.4%;\n P<\/jats:italic>\n = .004); however, there were no differences in average intraoperative systolic blood pressure or vasopressor administration.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n These results suggest that propofol is associated with a lower incidence of early PONV as compared to remimazolam; however, antiemetics are still recommended given the frequency of late PONV in both groups. Propofol also caused more episodes of intraoperative hypotension vs remimazolam, but the increase in transient hypotension is likely to be irrelevant during orthognathic surgery in healthy adults under the age of 60.<\/jats:p>\n <\/jats:sec>","DOI":"10.2344\/23-00002","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T08:42:31Z","timestamp":1715244151000},"page":"3-7","source":"Crossref","is-referenced-by-count":3,"title":["Retrospective Study on the Incidence of Postoperative Nausea and Vomiting and Hypotension During Orthognathic Surgery Using Propofol or Remimazolam"],"prefix":"10.2344","volume":"71","author":[{"given":"Rumi","family":"Kaneko","sequence":"first","affiliation":[{"name":"Postgraduate Student, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyotaro","family":"Koshika","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Shionoya","sequence":"additional","affiliation":[{"name":"Postgraduate Student, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Postgraduate Student, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Sendai","sequence":"additional","affiliation":[{"name":"Postgraduate Student, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutaka","family":"Matsuura","sequence":"additional","affiliation":[{"name":"Postgraduate Student, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Ichinohe","sequence":"additional","affiliation":[{"name":"Professor, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"issue":"5","key":"i1878-7177-71-1-3-b01","series-title":"Br J Anaesth","first-page":"742","article-title":"Evidence-based analysis of risk factors for postoperative nausea and vomiting","volume":"109","author":"Apfel CC,","year":"2012","unstructured":"Apfel CC,Heidrich FM,Jukar-Rao S, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth. 2012; 109(5):742\u2013753."},{"issue":"9","key":"i1878-7177-71-1-3-b02","series-title":"J Oral Maxillofac Surg","first-page":"1385","article-title":"Postoperative nausea and vomiting (PONV) after orthognathic surgery: a retrospective study and literature review","volume":"64","author":"Silva AC,","year":"2006","unstructured":"Silva AC,O\u2019Ryan F,Poor DB. Postoperative nausea and vomiting (PONV) after orthognathic surgery: a retrospective study and literature review. J Oral Maxillofac Surg. 2006; 64(9):1385\u20131397."},{"issue":"2","key":"i1878-7177-71-1-3-b03","series-title":"J Craniofac Surg","first-page":"584","article-title":"A comprehensive single-center analysis of postoperative nausea and vomiting following orthognathic surgery","volume":"33","author":"Pourtaheri N,","year":"2022","unstructured":"Pourtaheri N,Peck C,Maniskas S, et al. A comprehensive single-center analysis of postoperative nausea and vomiting following orthognathic surgery. J Craniofac Surg. 2022; 33(2):584\u2013587."},{"issue":"6","key":"i1878-7177-71-1-3-b04","series-title":"Int J Oral Maxillofac Surg","first-page":"744","article-title":"Postoperative nausea and vomiting following orthognathic surgery","volume":"44","author":"Pillips C,","year":"2015","unstructured":"Pillips C,Brookes CD,Rich J,Arbon J,Turvey TA. Postoperative nausea and vomiting following orthognathic surgery. Int J Oral Maxillofac Surg. 2015; 44(6):744\u2013751."},{"issue":"5","key":"i1878-7177-71-1-3-b05","series-title":"J Oral Maxillofac Surg","first-page":"936","article-title":"Nitrous oxide dose not aggravate postoperative emesis after orthognathic surgery in female and nonsmoking patients","volume":"65","author":"Ichinohe T,","year":"2007","unstructured":"Ichinohe T,Kaneko Y. Nitrous oxide dose not aggravate postoperative emesis after orthognathic surgery in female and nonsmoking patients. J Oral Maxillofac Surg. 2007; 65(5):936\u2013939."},{"issue":"6","key":"i1878-7177-71-1-3-b06","series-title":"J Oral Maxillofac Surg","first-page":"1245","article-title":"Remifentanil decreases mandibular bone marrow blood flow during propofol or sevoflurane anesthesia in rabbits","volume":"67","author":"Kemmochi M,","year":"2009","unstructured":"Kemmochi M,Ichinohe T,Kaneko Y. Remifentanil decreases mandibular bone marrow blood flow during propofol or sevoflurane anesthesia in rabbits. J Oral Maxillofac Surg. 2009; 67(6):1245\u20131250."},{"issue":"8","key":"i1878-7177-71-1-3-b07","series-title":"J Oral Maxillofac Surg","first-page":"2128","article-title":"Dose-dependent remifentanil decreases oral tissue blood flow during sevoflurane and propofol anesthesia in rabbits","volume":"69","author":"Koshika K,","year":"2011","unstructured":"Koshika K,Ichinohe T,Kaneko Y. Dose-dependent remifentanil decreases oral tissue blood flow during sevoflurane and propofol anesthesia in rabbits. J Oral Maxillofac Surg. 2011; 69(8):2128\u20132134."},{"issue":"3","key":"i1878-7177-71-1-3-b08","series-title":"Bull Tokyo Dent Coll","first-page":"169","article-title":"Propofol-remifentanil is more effective than propofol-fentanyl in decreasing intraoperative blood loss during sagittal split ramus osteotomy","volume":"57","author":"Handa T,","year":"2016","unstructured":"Handa T,Onodera T,Honda Y,Koukita Y,Ichinohe T. Propofol-remifentanil is more effective than propofol-fentanyl in decreasing intraoperative blood loss during sagittal split ramus osteotomy. Bull Tokyo Dent Coll. 2016; 57(3):169\u2013173."},{"issue":"1","key":"i1878-7177-71-1-3-b09","series-title":"Anesth Prog","first-page":"3","article-title":"Remifentanil reduces blood loss during orthognathic surgery","volume":"46","author":"Matsuura N,","year":"2017","unstructured":"Matsuura N,Okamura T,Ide S,Ichinohe T. Remifentanil reduces blood loss during orthognathic surgery. Anesth Prog. 2017; 46(1):3\u20137."},{"issue":"9","key":"i1878-7177-71-1-3-b10","series-title":"J Oral Maxillofac Surg","first-page":"1882.e1","article-title":"Propofol versus remifentanil: Which one is more effective in reducing blood loss during orthognathic surgery? A randomized clinical trial","volume":"76","author":"Eshghpour M,","year":"2018","unstructured":"Eshghpour M,Samieirad S,Attar SA,Kermari H,Seddigh S. Propofol versus remifentanil: Which one is more effective in reducing blood loss during orthognathic surgery? A randomized clinical trial. 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Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double blind, controlled trial. Pharmacol Res Perspect. 2021; 9(5):e00851."},{"issue":"5","key":"i1878-7177-71-1-3-b15","series-title":"J Clin Med","first-page":"2009","article-title":"Intraoperative hypotension is associated with postoperative nausea and vomiting in the PACU: a retrospective database analysis","volume":"12","author":"Maleczek M,","year":"2023","unstructured":"Maleczek M,Laxar D,Geroldinger A,Kimberger O. Intraoperative hypotension is associated with postoperative nausea and vomiting in the PACU: a retrospective database analysis. J Clin Med. 2023; 12(5):2009."},{"key":"i1878-7177-71-1-3-b16","series-title":"J Clin Anesth (Jpn)","first-page":"1281","article-title":"Comparison of remimazolam and propofol anesthesia on blood loss and postoperative nausea and vomiting in patients having received orthognathic surgery (in Japanese)","volume":"45","author":"Kaneko R,","year":"2021","unstructured":"Kaneko R,Koshika K,Matsuura N,Shimizu K,Shendai Y,Ichinohe T. Comparison of remimazolam and propofol anesthesia on blood loss and postoperative nausea and vomiting in patients having received orthognathic surgery (in Japanese). J Clin Anesth (Jpn). 2021; 45:1281\u20131285."},{"issue":"2","key":"i1878-7177-71-1-3-b17","series-title":"J Anesth","first-page":"265","article-title":"Remimazolam decreased the incidence of early postoperative nausea and vomiting compared to desflurane after laparoscopic gynecological surgery","volume":"36","author":"Hari Y,","year":"2022","unstructured":"Hari Y,Satomi S,Murakami C, et al. Remimazolam decreased the incidence of early postoperative nausea and vomiting compared to desflurane after laparoscopic gynecological surgery. J Anesth. 2022; 36(2):265\u2013269."},{"issue":"4","key":"i1878-7177-71-1-3-b18","series-title":"Korean J Anesthesiol","first-page":"334","article-title":"The comparative study to evaluate the effect of palonosetron monotherapy versus palonosetron with dexamethasone combination therapy for prevention of postoperative nausea and vomiting","volume":"63","author":"Park JW,","year":"2012","unstructured":"Park JW,Jun JW,Lim YH, et al. The comparative study to evaluate the effect of palonosetron monotherapy versus palonosetron with dexamethasone combination therapy for prevention of postoperative nausea and vomiting. Korean J Anesthesiol. 2012; 63(4):334\u2013339."},{"issue":"7","key":"i1878-7177-71-1-3-b19","series-title":"World Surg","first-page":"1525","article-title":"Propofol decreases early postoperative nausea and vomiting in patients undergoing thyroid and parathyroid operations","volume":"32","author":"Gauger PG,","year":"2008","unstructured":"Gauger PG,Shanks A,Morris M,Greenfield MVH,Burney RE,O\u2019Reilly M. Propofol decreases early postoperative nausea and vomiting in patients undergoing thyroid and parathyroid operations. World Surg. 2008; 32(7):1525\u20131534."},{"issue":"6","key":"i1878-7177-71-1-3-b20","series-title":"Anesth Analg","first-page":"1652","article-title":"The effects of systolic arterial blood pressure variations on postoperative nausea and vomiting","volume":"94","author":"Pusch F,","year":"2002","unstructured":"Pusch F,Berger A,Wilding E,Tiefenthaler W,Krafft P. The effects of systolic arterial blood pressure variations on postoperative nausea and vomiting. Anesth Analg. 2002; 94(6):1652\u20131655."},{"key":"i1878-7177-71-1-3-b21","series-title":"Braz J Anesthesiol","article-title":"Association between intraoperative hypotension and postoperative nausea and vomiting: a retrospective analysis of 247 thyroidectomy cases","author":"Nakatani H,","year":"2021","unstructured":"Nakatani H,Naito Y,Ida M, et al. Association between intraoperative hypotension and postoperative nausea and vomiting: a retrospective analysis of 247 thyroidectomy cases. Braz J Anesthesiol. Published online ahead of print March 22, 2021. doi:10.1016\/j.bjane.2021.02.029"},{"issue":"4","key":"i1878-7177-71-1-3-b22","series-title":"J Anesth","first-page":"543","article-title":"Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb\/III trial","volume":"34","author":"Doi M,","year":"2020","unstructured":"Doi M,Morita K,Takeda J,Sakamoto A,Yamakage M,Suzuki T. Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb\/III trial. J Anesth. 2020; 34(4):543\u2013553."},{"key":"i1878-7177-71-1-3-b23","series-title":"Anesthesiology","first-page":"1517","article-title":"Comparison of the effect-site keos of propofol for blood pressure and EEG bispectral index in elderly and younger patients","volume":"90","author":"Kazama T,","year":"1999","unstructured":"Kazama T,Ikeda K,Morita K, et al. Comparison of the effect-site keos of propofol for blood pressure and EEG bispectral index in elderly and younger patients. Anesthesiology. 1999; 90:1517\u20131527."},{"issue":"5","key":"i1878-7177-71-1-3-b01","series-title":"Br J Anaesth","first-page":"742","article-title":"Evidence-based analysis of risk factors for postoperative nausea and vomiting","volume":"109","author":"Apfel CC,","year":"2012","unstructured":"Apfel CC,Heidrich FM,Jukar-Rao S, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth. 2012; 109(5):742\u2013753."},{"issue":"9","key":"i1878-7177-71-1-3-b02","series-title":"J Oral Maxillofac Surg","first-page":"1385","article-title":"Postoperative nausea and vomiting (PONV) after orthognathic surgery: a retrospective study and literature review","volume":"64","author":"Silva AC,","year":"2006","unstructured":"Silva AC,O\u2019Ryan F,Poor DB. Postoperative nausea and vomiting (PONV) after orthognathic surgery: a retrospective study and literature review. J Oral Maxillofac Surg. 2006; 64(9):1385\u20131397."},{"issue":"2","key":"i1878-7177-71-1-3-b03","series-title":"J Craniofac Surg","first-page":"584","article-title":"A comprehensive single-center analysis of postoperative nausea and vomiting following orthognathic surgery","volume":"33","author":"Pourtaheri N,","year":"2022","unstructured":"Pourtaheri N,Peck C,Maniskas S, et al. A comprehensive single-center analysis of postoperative nausea and vomiting following orthognathic surgery. J Craniofac Surg. 2022; 33(2):584\u2013587."},{"issue":"6","key":"i1878-7177-71-1-3-b04","series-title":"Int J Oral Maxillofac Surg","first-page":"744","article-title":"Postoperative nausea and vomiting following orthognathic surgery","volume":"44","author":"Pillips C,","year":"2015","unstructured":"Pillips C,Brookes CD,Rich J,Arbon J,Turvey TA. Postoperative nausea and vomiting following orthognathic surgery. Int J Oral Maxillofac Surg. 2015; 44(6):744\u2013751."},{"issue":"5","key":"i1878-7177-71-1-3-b05","series-title":"J Oral Maxillofac Surg","first-page":"936","article-title":"Nitrous oxide dose not aggravate postoperative emesis after orthognathic surgery in female and nonsmoking patients","volume":"65","author":"Ichinohe T,","year":"2007","unstructured":"Ichinohe T,Kaneko Y. Nitrous oxide dose not aggravate postoperative emesis after orthognathic surgery in female and nonsmoking patients. J Oral Maxillofac Surg. 2007; 65(5):936\u2013939."},{"issue":"6","key":"i1878-7177-71-1-3-b06","series-title":"J Oral Maxillofac Surg","first-page":"1245","article-title":"Remifentanil decreases mandibular bone marrow blood flow during propofol or sevoflurane anesthesia in rabbits","volume":"67","author":"Kemmochi M,","year":"2009","unstructured":"Kemmochi M,Ichinohe T,Kaneko Y. Remifentanil decreases mandibular bone marrow blood flow during propofol or sevoflurane anesthesia in rabbits. J Oral Maxillofac Surg. 2009; 67(6):1245\u20131250."},{"issue":"8","key":"i1878-7177-71-1-3-b07","series-title":"J Oral Maxillofac Surg","first-page":"2128","article-title":"Dose-dependent remifentanil decreases oral tissue blood flow during sevoflurane and propofol anesthesia in rabbits","volume":"69","author":"Koshika K,","year":"2011","unstructured":"Koshika K,Ichinohe T,Kaneko Y. Dose-dependent remifentanil decreases oral tissue blood flow during sevoflurane and propofol anesthesia in rabbits. J Oral Maxillofac Surg. 2011; 69(8):2128\u20132134."},{"issue":"3","key":"i1878-7177-71-1-3-b08","series-title":"Bull Tokyo Dent Coll","first-page":"169","article-title":"Propofol-remifentanil is more effective than propofol-fentanyl in decreasing intraoperative blood loss during sagittal split ramus osteotomy","volume":"57","author":"Handa T,","year":"2016","unstructured":"Handa T,Onodera T,Honda Y,Koukita Y,Ichinohe T. Propofol-remifentanil is more effective than propofol-fentanyl in decreasing intraoperative blood loss during sagittal split ramus osteotomy. Bull Tokyo Dent Coll. 2016; 57(3):169\u2013173."},{"issue":"1","key":"i1878-7177-71-1-3-b09","series-title":"Anesth Prog","first-page":"3","article-title":"Remifentanil reduces blood loss during orthognathic surgery","volume":"46","author":"Matsuura N,","year":"2017","unstructured":"Matsuura N,Okamura T,Ide S,Ichinohe T. Remifentanil reduces blood loss during orthognathic surgery. Anesth Prog. 2017; 46(1):3\u20137."},{"issue":"9","key":"i1878-7177-71-1-3-b10","series-title":"J Oral Maxillofac Surg","first-page":"1882.e1","article-title":"Propofol versus remifentanil: Which one is more effective in reducing blood loss during orthognathic surgery? A randomized clinical trial","volume":"76","author":"Eshghpour M,","year":"2018","unstructured":"Eshghpour M,Samieirad S,Attar SA,Kermari H,Seddigh S. Propofol versus remifentanil: Which one is more effective in reducing blood loss during orthognathic surgery? A randomized clinical trial. J Oral Maxillofac Surg. 2018; 76(9):1882.e1\u20131882.e7."},{"issue":"24","key":"i1878-7177-71-1-3-b11","series-title":"N Engl J Med","first-page":"2441","article-title":"A factorial trial of six interventions for the prevention of postoperative nausea and vomiting","volume":"350","author":"Apfel CC,","year":"2004","unstructured":"Apfel CC,Korttila K,Abdalla M, et al.; IMPACT Investigators. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 2004; 350(24):2441\u20132451."},{"issue":"5","key":"i1878-7177-71-1-3-b12","series-title":"Br J Anaesth","first-page":"659","article-title":"Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design","volume":"88","author":"Apfel CC,","year":"2002","unstructured":"Apfel CC,Kranke P,Katz MH, et al. 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Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double blind, controlled trial. Pharmacol Res Perspect. 2021; 9(5):e00851."},{"issue":"5","key":"i1878-7177-71-1-3-b15","series-title":"J Clin Med","first-page":"2009","article-title":"Intraoperative hypotension is associated with postoperative nausea and vomiting in the PACU: a retrospective database analysis","volume":"12","author":"Maleczek M,","year":"2023","unstructured":"Maleczek M,Laxar D,Geroldinger A,Kimberger O. Intraoperative hypotension is associated with postoperative nausea and vomiting in the PACU: a retrospective database analysis. J Clin Med. 2023; 12(5):2009."},{"key":"i1878-7177-71-1-3-b16","series-title":"J Clin Anesth (Jpn)","first-page":"1281","article-title":"Comparison of remimazolam and propofol anesthesia on blood loss and postoperative nausea and vomiting in patients having received orthognathic surgery (in Japanese)","volume":"45","author":"Kaneko R,","year":"2021","unstructured":"Kaneko R,Koshika K,Matsuura N,Shimizu K,Shendai Y,Ichinohe T. Comparison of remimazolam and propofol anesthesia on blood loss and postoperative nausea and vomiting in patients having received orthognathic surgery (in Japanese). J Clin Anesth (Jpn). 2021; 45:1281\u20131285."},{"issue":"2","key":"i1878-7177-71-1-3-b17","series-title":"J Anesth","first-page":"265","article-title":"Remimazolam decreased the incidence of early postoperative nausea and vomiting compared to desflurane after laparoscopic gynecological surgery","volume":"36","author":"Hari Y,","year":"2022","unstructured":"Hari Y,Satomi S,Murakami C, et al. Remimazolam decreased the incidence of early postoperative nausea and vomiting compared to desflurane after laparoscopic gynecological surgery. J Anesth. 2022; 36(2):265\u2013269."},{"issue":"4","key":"i1878-7177-71-1-3-b18","series-title":"Korean J Anesthesiol","first-page":"334","article-title":"The comparative study to evaluate the effect of palonosetron monotherapy versus palonosetron with dexamethasone combination therapy for prevention of postoperative nausea and vomiting","volume":"63","author":"Park JW,","year":"2012","unstructured":"Park JW,Jun JW,Lim YH, et al. The comparative study to evaluate the effect of palonosetron monotherapy versus palonosetron with dexamethasone combination therapy for prevention of postoperative nausea and vomiting. Korean J Anesthesiol. 2012; 63(4):334\u2013339."},{"issue":"7","key":"i1878-7177-71-1-3-b19","series-title":"World Surg","first-page":"1525","article-title":"Propofol decreases early postoperative nausea and vomiting in patients undergoing thyroid and parathyroid operations","volume":"32","author":"Gauger PG,","year":"2008","unstructured":"Gauger PG,Shanks A,Morris M,Greenfield MVH,Burney RE,O\u2019Reilly M. Propofol decreases early postoperative nausea and vomiting in patients undergoing thyroid and parathyroid operations. World Surg. 2008; 32(7):1525\u20131534."},{"issue":"6","key":"i1878-7177-71-1-3-b20","series-title":"Anesth Analg","first-page":"1652","article-title":"The effects of systolic arterial blood pressure variations on postoperative nausea and vomiting","volume":"94","author":"Pusch F,","year":"2002","unstructured":"Pusch F,Berger A,Wilding E,Tiefenthaler W,Krafft P. The effects of systolic arterial blood pressure variations on postoperative nausea and vomiting. 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