Association of Postoperative Nausea-Vomiting (PONV) Incidence with Neutrophil-Lymphocyte Ratio (NLR) in Ambulatory Maxillofacial Surgeries

Publication date: Available online 4 January 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Ayşe Hande Arpaci, Berrin Işik, Eren Ilhan, Erdal Erdem
PurposePostoperative nausea and vomiting (PONV) constitutes an important factor in ambulatory surgery. Mechanisms of the anti-emetic action of potent anti-inflammatory corticosteroids, which are used extensively for the treatment of PONV, and association between PONV and inflammation, have not been investigated sufficiently. In the present study we aimed at establishing the association between neutrophil-lymphocyte ratio (NLR) and postoperative antiemetic administration, as well as investigating whether NLR would be a biomarker for PONV.Materials and MethodsAnesthesia records of the ASAI-II cases who underwent ambulatory routine oral surgery under general anesthesia were evaluated after obtaining ethical approval from the faculty ethics committee. 5-point scale was used to score postoperative nausea and vomiting. Metoclopramide (Metpamid^®) was used as the first choice in patients who had PONV scale score of 1 or higher. Data belonging to metoclopramide administration during extubation and discharge periods were analyzed.Sixty-four patients were randomized and enrolled in the study as NLR<2 [Group I (n=37)] or NLR>2 [Group II (n=27)] and metoclopramide administration was evaluated in each case. The association between NLR and metoclopramide administration was analyzed statistically using descriptive statistical method in detecting frequencies, chi-square in comparison of the groups and t-test in independent groups.ResultsMetoclopramide administration frequency for PONV was 5.4% in Group I, 96.3% in Group II. Metoclopramide administration frequency in Group II was statistically higher than Group I (p<0,001).ConclusionsWe are of the opinion that NLR can be easily calculated with data obtained from complete blood count, and could be a marker for PONV. Antiemetic prophylaxis could be given after evaluating NLR ratio. However, we suggest that this result should be supported with further prospective studies using a larger series.



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