Effect of a Multimodal Antiemetic Protocol on Postoperative Nausea and Vomiting in Patients Undergoing Flap Surgery for Head and Neck Cancer

Effect of a Multimodal Antiemetic Protocol on Postoperative Nausea and Vomiting in Patients Undergoing Flap Surgery for Head and Neck Cancer: A Prospective Randomized Controlled Trial

This prospective randomized controlled trial evaluates whether a multimodal antiemetic protocol can reduce postoperative nausea and vomiting (PONV) in patients undergoing flap surgery for head and neck cancer. Seventy-two patients will be randomized to receive either standard dexamethasone-based prophylaxis or a multimodal protocol incorporating TIVA, superficial cervical plexus block, palonosetron, dexamethasone, and acetaminophen. PONV, postoperative pain, quality of recovery, and other postoperative outcomes will be compared.

Inclusion Criteria:

• Patients aged 19 years or older undergoing elective flap surgery for head and neck cancer

Exclusion Criteria:

• Patients who do not consent to participate in the study
• Patients undergoing emergency surgery
• Patients with signs of inflammation (such as erythema) at the nerve block injection site
• Patients with a history of hypersensitivity or adverse reactions to ropivacaine
• Patients with difficulty completing questionnaires due to conditions such as dementia or delirium
• Patients with severe cardiopulmonary disease
• Patients with QT prolongation on preoperative ECG Patients deemed unsuitable for participation by the investigator