{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T03:02:38Z","timestamp":1779850958037,"version":"3.53.1"},"reference-count":30,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"\n Objective<\/jats:title>\n This study aimed to compare the incidence of postoperative nausea and vomiting (PONV) between propofol-based and remimazolam-based anesthesia in combination with dexamethasone and ondansetron.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Subjects were 20 to 50 years of age with a preoperative American Society of Anesthesiologists physical status classification I or II scheduled for bilateral sagittal split ramus osteotomy and genioplasty. General anesthesia was induced and maintained using propofol or remimazolam, and dexamethasone (6.6 mg) was administered after intubation. Ondansetron (4 mg) was administered intravenously 15 minutes before the end of surgery. Incidence of PONV was assessed overall and at 3 periods within the first 24 hours after anesthesia. Severity of PONV was assessed using a numerical rating scale (NRS), and quality of recovery was also assessed. Intravenous metoclopramide (10 mg) was administered for rescue in those with an NRS score greater than 4.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 100 subjects participated in this study and had an incidence of overall PONV that was higher with remimazolam (18%) than with propofol (6%) but lacked significance (\n P<\/jats:italic>\n = .12). There were no significant differences in PONV at any of the periods, nor in mean NRS scores, quality of recovery, or metoclopramide use.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The incidence of PONV during 24 hours after orthognathic surgery was not significantly different when using remimazolam-based anesthesia vs propofol-based anesthesia in combination with dexamethasone and ondansetron. There were also no significant differences in the severity of PONV or the quality of recovery between the 2 groups.<\/jats:p>\n <\/jats:sec>","DOI":"10.2344\/24-0029","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T11:10:04Z","timestamp":1765365004000},"page":"218-223","source":"Crossref","is-referenced-by-count":0,"title":["Does Propofol-based or Remimazolam-based Anesthesia Impact the Incidence of Postoperative Nausea and Vomiting When Used In Combination With Prophylactic Dexamethasone and Ondansetron?"],"prefix":"10.2344","volume":"72","author":[{"given":"Ai","family":"Nakakuki","sequence":"first","affiliation":[{"name":"Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyotaro","family":"Koshika","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanari","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momoka","family":"Nishino","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rika","family":"Nomura","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariko","family":"Iimura","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natsuki","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaori","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Handa","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Ichinohe","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"key":"i1878-7177-72-4-218-b01","series-title":"Anesthesiology","first-page":"162","article-title":"Postoperative nausea and vomiting: its etiology, treatment, and prevention","volume":"77","author":"Watcha MF,","year":"1992","unstructured":"Watcha MF,\nWhite PF. Postoperative nausea and vomiting: its etiology, treatment, and prevention. Anesthesiology. 1992;77:162\u2013184."},{"issue":"3","key":"i1878-7177-72-4-218-b02","series-title":"Anesthesiology","first-page":"693","article-title":"A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers","volume":"91","author":"Apfel CC,","year":"1999","unstructured":"Apfel CC,\nL\u00e4\u00e4r\u00e4 E,\nKoivuranta M,\nGreim CA,\nRoewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers Anesthesiology. 1999;91(3):693\u2013700."},{"issue":"6","key":"i1878-7177-72-4-218-b03","series-title":"Int J Oral Maxillofac Surg","first-page":"745","article-title":"Postoperative nausea and vomiting following orthognathic surgery","volume":"44","author":"Philips C,","year":"2015","unstructured":"Philips C,\nBrookes CD,\nRich J,\nArbon J,\nTurvey TA. Postoperative nausea and vomiting following orthognathic surgery. Int J Oral Maxillofac Surg. 2015;44(6):745\u2013751."},{"issue":"5","key":"i1878-7177-72-4-218-b04","series-title":"Jpn J Oral Maxillofac Surg","first-page":"1047","article-title":"Research on the safety management of intermaxillary fixation in postoperative period: examination of questionnaires (in Japanese)","volume":"37","author":"Kubota Y,","year":"1991","unstructured":"Kubota Y,\nAyuse T,\nIto H, et al. Research on the safety management of intermaxillary fixation in postoperative period: examination of questionnaires (in Japanese). Jpn J Oral Maxillofac Surg. 1991;37(5):1047\u20131054."},{"key":"i1878-7177-72-4-218-b05","series-title":"Anesth Prog","first-page":"3","article-title":"Dexamethasone and ondansetron combined decreases postoperative nausea and vomiting in orthognathic surgery compared with dexamethasone alone: a prospective randomized controlled trial","volume":"72","author":"Kang Y,","year":"2025","unstructured":"Kang Y,\nKoshika K,\nTakashima K, et al. Dexamethasone and ondansetron combined decreases postoperative nausea and vomiting in orthognathic surgery compared with dexamethasone alone: a prospective randomized controlled trial. Anesth Prog. 2025;72:3\u20138."},{"key":"i1878-7177-72-4-218-b06","series-title":"Anesth Prog","first-page":"3","article-title":"Comparison of remimazolam and propofol anesthesia on blood loss and postoperative nausea and vomiting in patients having received orthognathic surgery","volume":"71","author":"Kaneko R,","year":"2024","unstructured":"Kaneko R,\nKoshika K,\nShionoya M, et al. Comparison of remimazolam and propofol anesthesia on blood loss and postoperative nausea and vomiting in patients having received orthognathic surgery. Anesth Prog. 2024;71:3\u20137."},{"issue":"1","key":"i1878-7177-72-4-218-b07","series-title":"Br J Anaesth","first-page":"11","article-title":"Validity and reliability of a postoperative quality of recovery score: the QoR-40","volume":"84","author":"Myles PS,","year":"2000","unstructured":"Myles PS,\nWeitkamp B,\nJones K,\nMelick J,\nHensen S. Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth. 2000;84(1):11\u201315."},{"issue":"2","key":"i1878-7177-72-4-218-b08","series-title":"Korean J Anesthesiol","first-page":"143","article-title":"Comparison of postoperative nausea and vomiting between remimazolam and propofol: a propensity score-matched, retrospective, observational, single-center cohort study","volume":"76","author":"Suzuki Y,","year":"2023","unstructured":"Suzuki Y,\nKawashima S,\nMakino H,\nDoi M,\nNakajima Y. Comparison of postoperative nausea and vomiting between remimazolam and propofol: a propensity score-matched, retrospective, observational, single-center cohort study. Korean J Anesthesiol. 2023;76(2):143\u2013151."},{"issue":"1","key":"i1878-7177-72-4-218-b09","series-title":"BMC Anesthesiol","first-page":"132","article-title":"Comparison of postoperative nausea and vomiting between remimazolam and propofol in patients undergoing oral and maxillofacial surgery: a prospective randomized controlled trial","volume":"23","author":"Kim EJ,","year":"2023","unstructured":"Kim EJ,\nKim CH,\nYoon JY,\nByeon GJ,\nKim HY,\nChoi EJ. Comparison of postoperative nausea and vomiting between remimazolam and propofol in patients undergoing oral and maxillofacial surgery: a prospective randomized controlled trial. BMC Anesthesiol. 2023;23(1):132."},{"issue":"2","key":"i1878-7177-72-4-218-b10","series-title":"Anesth Analg","first-page":"411","article-title":"Fourth consensus guidelines for the management of postoperative nausea and vomiting","volume":"131","author":"Gan TJ,","year":"2020","unstructured":"Gan TJ,\nBelani KG,\nBergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2020;131(2):411\u2013448."},{"key":"i1878-7177-72-4-218-b11","series-title":"J Anesthesia","first-page":"493","article-title":"A population pharmacokinetic model of remimazolam for general anesthesia and consideration of remimazolam dose in clinical practice","volume":"36","author":"Masui K,","year":"2022","unstructured":"Masui K,\nSt\u00f6hr T,\nPesic M,\nTonai T. A population pharmacokinetic model of remimazolam for general anesthesia and consideration of remimazolam dose in clinical practice. J Anesthesia. 2022;36:493\u2013505."},{"key":"i1878-7177-72-4-218-b12","series-title":"Drug Des Devel Ther","first-page":"631","article-title":"Clinical study of flumazenil antagonizing remimazolam on nausea and vomiting after gynecologic day surgery","volume":"18","author":"Wei Y,","year":"2024","unstructured":"Wei Y,\nZhu M,\nMan Y, et al. Clinical study of flumazenil antagonizing remimazolam on nausea and vomiting after gynecologic day surgery. Drug Des Devel Ther. 2024;18:631\u2013638."},{"issue":"1","key":"i1878-7177-72-4-218-b13","series-title":"Anaesthesia","first-page":"18","article-title":"Midazolam vs ondansetron for preventing postoperative nausea and vomiting: a randomized controlled trial","volume":"62","author":"Lee Y,","year":"2007","unstructured":"Lee Y,\nWang JJ,\nYang YL,\nChen A,\nLai HY. Midazolam vs ondansetron for preventing postoperative nausea and vomiting: a randomized controlled trial. Anaesthesia. 2007;62(1):18\u201322."},{"issue":"4","key":"i1878-7177-72-4-218-b14","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,\nMorita K,\nTakeda J,\nSakamoto A,\nYamakage M,\nSuzuki 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."},{"issue":"3","key":"i1878-7177-72-4-218-b15","series-title":"J Oral Maxillofac Surg","first-page":"279","article-title":"Is postoperative pain associated with nausea and vomiting following orthognathic surgery","volume":"82","author":"Ya\u015fh SO,","year":"2024","unstructured":"Ya\u015fh SO,\nCanpolat DG,\nDogruel F,\nDemirba\u015f AE. Is postoperative pain associated with nausea and vomiting following orthognathic surgery? J Oral Maxillofac Surg. 2024;82(3):279\u2013287."},{"key":"i1878-7177-72-4-218-b01","series-title":"Anesthesiology","first-page":"162","article-title":"Postoperative nausea and vomiting: its etiology, treatment, and prevention","volume":"77","author":"Watcha MF,","year":"1992","unstructured":"Watcha MF,\nWhite PF. Postoperative nausea and vomiting: its etiology, treatment, and prevention. Anesthesiology. 1992;77:162\u2013184."},{"issue":"3","key":"i1878-7177-72-4-218-b02","series-title":"Anesthesiology","first-page":"693","article-title":"A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers","volume":"91","author":"Apfel CC,","year":"1999","unstructured":"Apfel CC,\nL\u00e4\u00e4r\u00e4 E,\nKoivuranta M,\nGreim CA,\nRoewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers Anesthesiology. 1999;91(3):693\u2013700."},{"issue":"6","key":"i1878-7177-72-4-218-b03","series-title":"Int J Oral Maxillofac Surg","first-page":"745","article-title":"Postoperative nausea and vomiting following orthognathic surgery","volume":"44","author":"Philips C,","year":"2015","unstructured":"Philips C,\nBrookes CD,\nRich J,\nArbon J,\nTurvey TA. Postoperative nausea and vomiting following orthognathic surgery. Int J Oral Maxillofac Surg. 2015;44(6):745\u2013751."},{"issue":"5","key":"i1878-7177-72-4-218-b04","series-title":"Jpn J Oral Maxillofac Surg","first-page":"1047","article-title":"Research on the safety management of intermaxillary fixation in postoperative period: examination of questionnaires (in Japanese)","volume":"37","author":"Kubota Y,","year":"1991","unstructured":"Kubota Y,\nAyuse T,\nIto H, et al. Research on the safety management of intermaxillary fixation in postoperative period: examination of questionnaires (in Japanese). Jpn J Oral Maxillofac Surg. 1991;37(5):1047\u20131054."},{"key":"i1878-7177-72-4-218-b05","series-title":"Anesth Prog","first-page":"3","article-title":"Dexamethasone and ondansetron combined decreases postoperative nausea and vomiting in orthognathic surgery compared with dexamethasone alone: a prospective randomized controlled trial","volume":"72","author":"Kang Y,","year":"2025","unstructured":"Kang Y,\nKoshika K,\nTakashima K, et al. Dexamethasone and ondansetron combined decreases postoperative nausea and vomiting in orthognathic surgery compared with dexamethasone alone: a prospective randomized controlled trial. Anesth Prog. 2025;72:3\u20138."},{"key":"i1878-7177-72-4-218-b06","series-title":"Anesth Prog","first-page":"3","article-title":"Comparison of remimazolam and propofol anesthesia on blood loss and postoperative nausea and vomiting in patients having received orthognathic surgery","volume":"71","author":"Kaneko R,","year":"2024","unstructured":"Kaneko R,\nKoshika K,\nShionoya M, et al. Comparison of remimazolam and propofol anesthesia on blood loss and postoperative nausea and vomiting in patients having received orthognathic surgery. Anesth Prog. 2024;71:3\u20137."},{"issue":"1","key":"i1878-7177-72-4-218-b07","series-title":"Br J Anaesth","first-page":"11","article-title":"Validity and reliability of a postoperative quality of recovery score: the QoR-40","volume":"84","author":"Myles PS,","year":"2000","unstructured":"Myles PS,\nWeitkamp B,\nJones K,\nMelick J,\nHensen S. Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth. 2000;84(1):11\u201315."},{"issue":"2","key":"i1878-7177-72-4-218-b08","series-title":"Korean J Anesthesiol","first-page":"143","article-title":"Comparison of postoperative nausea and vomiting between remimazolam and propofol: a propensity score-matched, retrospective, observational, single-center cohort study","volume":"76","author":"Suzuki Y,","year":"2023","unstructured":"Suzuki Y,\nKawashima S,\nMakino H,\nDoi M,\nNakajima Y. Comparison of postoperative nausea and vomiting between remimazolam and propofol: a propensity score-matched, retrospective, observational, single-center cohort study. Korean J Anesthesiol. 2023;76(2):143\u2013151."},{"issue":"1","key":"i1878-7177-72-4-218-b09","series-title":"BMC Anesthesiol","first-page":"132","article-title":"Comparison of postoperative nausea and vomiting between remimazolam and propofol in patients undergoing oral and maxillofacial surgery: a prospective randomized controlled trial","volume":"23","author":"Kim EJ,","year":"2023","unstructured":"Kim EJ,\nKim CH,\nYoon JY,\nByeon GJ,\nKim HY,\nChoi EJ. Comparison of postoperative nausea and vomiting between remimazolam and propofol in patients undergoing oral and maxillofacial surgery: a prospective randomized controlled trial. BMC Anesthesiol. 2023;23(1):132."},{"issue":"2","key":"i1878-7177-72-4-218-b10","series-title":"Anesth Analg","first-page":"411","article-title":"Fourth consensus guidelines for the management of postoperative nausea and vomiting","volume":"131","author":"Gan TJ,","year":"2020","unstructured":"Gan TJ,\nBelani KG,\nBergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2020;131(2):411\u2013448."},{"key":"i1878-7177-72-4-218-b11","series-title":"J Anesthesia","first-page":"493","article-title":"A population pharmacokinetic model of remimazolam for general anesthesia and consideration of remimazolam dose in clinical practice","volume":"36","author":"Masui K,","year":"2022","unstructured":"Masui K,\nSt\u00f6hr T,\nPesic M,\nTonai T. A population pharmacokinetic model of remimazolam for general anesthesia and consideration of remimazolam dose in clinical practice. J Anesthesia. 2022;36:493\u2013505."},{"key":"i1878-7177-72-4-218-b12","series-title":"Drug Des Devel Ther","first-page":"631","article-title":"Clinical study of flumazenil antagonizing remimazolam on nausea and vomiting after gynecologic day surgery","volume":"18","author":"Wei Y,","year":"2024","unstructured":"Wei Y,\nZhu M,\nMan Y, et al. Clinical study of flumazenil antagonizing remimazolam on nausea and vomiting after gynecologic day surgery. Drug Des Devel Ther. 2024;18:631\u2013638."},{"issue":"1","key":"i1878-7177-72-4-218-b13","series-title":"Anaesthesia","first-page":"18","article-title":"Midazolam vs ondansetron for preventing postoperative nausea and vomiting: a randomized controlled trial","volume":"62","author":"Lee Y,","year":"2007","unstructured":"Lee Y,\nWang JJ,\nYang YL,\nChen A,\nLai HY. Midazolam vs ondansetron for preventing postoperative nausea and vomiting: a randomized controlled trial. Anaesthesia. 2007;62(1):18\u201322."},{"issue":"4","key":"i1878-7177-72-4-218-b14","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,\nMorita K,\nTakeda J,\nSakamoto A,\nYamakage M,\nSuzuki 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."},{"issue":"3","key":"i1878-7177-72-4-218-b15","series-title":"J Oral Maxillofac Surg","first-page":"279","article-title":"Is postoperative pain associated with nausea and vomiting following orthognathic surgery","volume":"82","author":"Ya\u015fh SO,","year":"2024","unstructured":"Ya\u015fh SO,\nCanpolat DG,\nDogruel F,\nDemirba\u015f AE. Is postoperative pain associated with nausea and vomiting following orthognathic surgery? J Oral Maxillofac Surg. 2024;82(3):279\u2013287."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/72\/4\/article-p218.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/72\/4\/article-p218.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/72\/4\/article-p218.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T02:20:13Z","timestamp":1779848413000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/72\/4\/article-p218.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":30,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.2344\/24-0029","relation":{},"ISSN":["1878-7177","0003-3006"],"issn-type":[{"value":"1878-7177","type":"electronic"},{"value":"0003-3006","type":"print"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}