Comparison of different hypotensive anaesthesia techniques in orthognathic surgery with regard to intraoperative blood loss, quality of the surgical field, and postoperative nausea and vomiting

Lin, Shang-Hung; Chen, C.; Yao, Chuan-Fong; Chen, Y.-A.; Chen, Y.-R.

doi:10.1016/j.ijom.2016.09.005

Cited by 27 publications

(18 citation statements)

References 16 publications

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“…Basu9 claimed that fibrinolysis increases during menstruation, which reflects the increased risk of bleeding during this period. Lin et al10 reported that hypotensive anesthesia using sevoflurane can effectively reduce bleeding and secure excellent vision during surgery.…”

Section: Intraoperative Complicationsmentioning

confidence: 99%

“…Although updated consensus guidelines were introduced in 2007 to lower rates of vomiting and nausea, the rates have not decreased compared with the rates in the period from 2003 to 2004138. Lin et al10 claimed that postoperative nausea and vomiting can be significantly reduced by limiting the use of narcotics after surgery for pain control. Postoperative pain can be effectively controlled with non-steroidal anti-inflammatory drugs (NSAIDs) or COX-2 inhibitors.…”

Section: Postoperative Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Complications associated with orthognathic surgery

Kim

2017

J Korean Assoc Oral Maxillofac Surg

118

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While most patients undergo orthognathic surgery for aesthetic purposes, aesthetic improvements are most often followed by postoperative functional complications. Therefore, patients must carefully decide whether their purpose of undergoing orthognathic surgery lies on the aesthetic side or the functional side. There is a wide variety of complications associated with orthognathic surgery. There should be a clear distinction between malpractice and complications. Complications can be resolved without any serious problems if the cause is detected early and adequate treatment provided. Oral and maxillofacial surgeons must have a full understanding of the types, causes, and treatment of complications, and should deliver this information to patients who develop these complications.

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Section: Intraoperative Complicationsmentioning

confidence: 99%

Section: Postoperative Complicationsmentioning

confidence: 99%

Complications associated with orthognathic surgery

Kim

2017

J Korean Assoc Oral Maxillofac Surg

118

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“…Besides the malaise caused by blood loss, postoperative vomiting increases the pressure in the newly operated region and causes an increasing of the edema. In addition, due to the bleeding caused by the pressure increasing, there may be formation and/or increasing of hematomas [24][25][26].…”

Section: Blood Lossmentioning

confidence: 99%

“…Lower mean blood pressure reduces transoperative bleeding, reducing as well the amount of blood lost, improving the visualization of the surgical field, reducing surgical time, and the formation of hematomas and swelling [27][28][29][30]. The hypotension induced during surgery is a strategy to improve the surgical field through the reduction of bleeding and consequently reducing surgical time and postoperative inflammatory process [24,27,28,31]. Induced hypotension, or controlled hypotension, is defined by the reduction of systolic blood pressure to 80-90 mmHg with a reduction in mean arterial pressure (MAP) to 50-65 mmHg or a 30% reduction in MAP [30,32].…”

Section: Induced Hypotensionmentioning

confidence: 99%

Edema Management in Oral and Maxillofacial Surgery

Yaedú¹,

Mello²,

Silveira³

et al. 2022

Inflammation in the 21st Century

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This chapter will discuss the expected edema and intercurrences in maxillofacial surgery, which involves important anatomical structures, such as the upper airways. It will also discuss important issues such as intrinsic and extrinsic enhancers of edema and the main consequences of a severe edema setting according to physiological, functional, and psychosocial points of view. Edema assessment and measurement is still performed subjectively in the clinical routine. However, for the accomplishment of studies, more objective forms are being tested, but still not very successful for clinical applicability. It is known that the best way to deal with edema is prevention; so in elective surgeries, much is discussed about the best management forms. This way, besides edema prevention, it is important not to cause unwanted reactions for the patient or in the performed procedure. Therefore, it will also be debated about preoperative medications and their consequences. Another point discussed involves main treatments for the underdeveloping edema and the one already installed, such as manual lymphatic drainage therapy, a treatment that is well known and used in other specialties, but is still very little widespread among maxillofacial surgeons.

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“…In our referral craniofacial center for OGS treatment, we have treated a high volume of patients in the past 30 years [9,10,11,12,13,14,15,16,17,18]. Our evolving comprehensive OGS care method, which is based on a multidisciplinary team-based OGS approach with condition-specific practical perioperative guidelines, has permitted us to successfully maximize the risk–benefit ratio of OGS in patients with underlying high-risk conditions.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Orthognathic Surgery Outcomes Between Patients With and Without Underlying High-Risk Conditions: A Multidisciplinary Team-Based Approach and Practical Guidelines

Chou

Denadai

Chen

et al. 2019

JCM

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Orthognathic surgery (OGS) has been successfully adopted for managing a wide spectrum of skeletofacial deformities, but patients with underlying conditions have not been treated using OGS because of the relatively high risk of surgical anesthetic procedure-related complications. This study compared the OGS outcomes of patients with and without underlying high-risk conditions, which were managed using a comprehensive, multidisciplinary team-based OGS approach with condition-specific practical perioperative care guidelines. Data of surgical anesthetic outcomes (intraoperative blood loss, operative duration, need for prolonged intubation, reintubation, admission to an intensive care unit, length of hospital stay, and complications), facial esthetic outcomes (professional panel assessment), and patient-reported outcomes (FACE-Q social function, psychological well-being, and satisfaction with decision scales) of consecutive patients with underlying high-risk conditions (n = 30) treated between 2004 and 2017 were retrospectively collected. Patients without these underlying conditions (n = 30) treated during the same period were randomly selected for comparison. FACE-Q reports of 50 ethnicity-, sex-, and age-matched healthy individuals were obtained. The OGS-treated patients with and without underlying high-risk conditions differed significantly in their American Society of Anesthesiologists Physical Status (ASA-PS) classification (p < 0.05), Charlson comorbidity scores, and Elixhauser comorbidity scores. The two groups presented similar outcomes (all p > 0.05) for all assessed outcome parameters, except for intraoperative blood loss (p < 0.001; 974.3 ± 592.7 mL vs. 657.6 ± 355.0 mL). Comparisons with healthy individuals revealed no significant differences (p > 0.05). The patients with underlying high-risk conditions treated using a multidisciplinary team-based OGS approach and the patients without the conditions had similar OGS-related outcomes.

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Comparison of different hypotensive anaesthesia techniques in orthognathic surgery with regard to intraoperative blood loss, quality of the surgical field, and postoperative nausea and vomiting

Cited by 27 publications

References 16 publications

Complications associated with orthognathic surgery

Complications associated with orthognathic surgery

Edema Management in Oral and Maxillofacial Surgery

Comparison of Orthognathic Surgery Outcomes Between Patients With and Without Underlying High-Risk Conditions: A Multidisciplinary Team-Based Approach and Practical Guidelines

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