Prevalence and Associated Factors of Postoperative Nausea and Vomiting After Maxillofacial Surgery Under General Anaesthesia at Federal Medical Centre Owerri

Postoperative nausea and vomiting (PONV) is a prevalent and distressing complication of general anaesthesia, with a reported incidence of 20 to 30% in the general surgical population. In maxillofacial surgery, where airway management is shared and blood and secretions are frequently ingested intraoperatively, the risk of PONV may be elevated. This prospective observational study quantifies the incidence, severity, and associated risk factors for PONV among patients undergoing maxillofacial procedures under general anaesthesia at Federal Medical Centre Owerri, South East Nigeria. One hundred and eight consecutive patients who underwent elective and emergency maxillofacial procedures under general anaesthesia over a 12-month period were enrolled. PONV occurrence was assessed at 2, 6, and 24 hours postoperatively using a validated categorical scale. Patient risk factors including sex, age, non-smoking status, history of PONV, anaesthetic agents used, duration of anaesthesia, opioid dose, and procedure type were evaluated by multivariate logistic regression. Results indicate an overall PONV incidence of 34.3% at 24 hours. Female sex, non-smoking status, use of volatile inhalation agents, and duration of surgery exceeding two hours were independently associated with PONV. Patients undergoing mandibular fracture repair demonstrated the highest PONV incidence. The study recommends routine Apfel PONV risk scoring before maxillofacial general anaesthesia and the implementation of a prophylactic antiemetic protocol stratified by risk score at FMC Owerri. Keywords: postoperative nausea and vomiting, maxillofacial surgery, general anaesthesia, risk factors, Owerri.