SUMMARY:
A study was concluded on 6 patients undergoing osteotomy procedures for facial correction. The study population consisted of two groups. One group of 3 patients (normotensive anesthesia group) and the other group of 3 patients (hypotension anesthesia group), a comparative study on blood loss intra-operatively in these two groups were studied by assessing and comparing the blood loss estimated by the surgeon, anesthetist and surgical field.
The drugs used for anesthesia for the normotensive groups were nitrous oxide and halothane and for the hypotensive group the addition of nitroglycerine and esmolol. Blood loss was evaluated by the surgeon, anesthetist and according to Fromme's scale of surgical grading at intervals of 15 minutes from the onset of procedure to the end of the procedure.
Our study showed that there is a significant difference between the blood loss in both the groups, and induced hypotension anesthesia group showed reduced blood loss as assessed by the surgeon, anesthetist and according to Fromme's scale. There was neither any organ dysfunction due to tissue hypoxia in any one of the subjects nor any complications.
CONCLUSION:
Technique for minimizing blood loss are important for reducing the need for transfusion and the potential risk of a transfusion reaction or the transmission of blood borne pathogens. This is especially relevant when considering the elective nature of orthognathic surgery. Induced hypotensive anesthesia is a useful and safe technique in the orthognathic population when properly applied and executed.
Further well-designed, prospective investigations are needed to define, which agents are most efficient and safe; the recommended parameters of induced hypotensive anesthesia with respect to blood pressure reduction; and effect on blood loss using most accurately available qualifying technique. Induced hypotension anesthesia not only reduced the blood loss, but also provides a blood loss field helping the surgeon to work more effectively and minimize the time of surgery.
Hence, induced hypotensive anesthesia should routinely be applied especially in elective surgeries like orthognathic surgeries, which is of high beneficial value
