Medication Protocol

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Perioperative Medication Protocol for Orthognathic Surgery
Chang Gung Craniofacial Center

Reduce infection—Prophylactic Antibiotic Regimen

  1. Cefazolin 1g IV 30min, before incision; 500mg IV every 4 hours, during surgery
  2. IV Cefazolin 1g IV Q8H plus Clindamycin 300mg IVF Q8H for 2 days, at hospital
  3. Amoxicillin 500mg PO Q8H for 5 days, after dischage

Pain Control

  1. Preemptive Analgesia: Parecoxib 40mg IV 30min before incision
  2. Nerve Block: Levobupivacaine(Chirocaine) 0.5% with epinephrine 1:100000 for maxillary(V2) and mandibular block(V3), before incision
  3. Postoperative Analgesia: Ibuprofen 400mg PO QID, after patient start intake(POD 1); Parecoxib
    40mg IV Q12H, if necessary

Postoperative Nausea and Vomiting(PONV) Prophylaxis

  1. Ondansetron 8mg IV, at end of surgery
  2. Dexamethasone 5mg IV, at induction

Reduce Swelling

Dexamethasone 5mg IV, at induction; 5mg IV Q8H for 1 day

Reduce Bleeding

Tranexamic acid 500mg IV at induction; 250mg IV Q8H for 1 day


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