Schaberg S J, Kelly J F, Terry B C, Posner M A, Anderson E F
J Oral Surg. 1976 Feb;34(2):147-56.
To evaluate accurately changes in blood volume during oral-facial corrective surgery, double-tagged radioisotope blood volume studies were performed preoperatively and postoperatively. Unexpectedly large RCV deficits that were not consistent with EBL were observed in studies conducted at two separate facilities. Hypotensive general anesthesia was used for the intended purpose of reducing blood loss in oral-facial corrective surgery. Various physiological parameters were measured preoperatively, intraoperatively, and postoperatively to evaluate patient response to this anesthetic method. The MAP was reduced from 89.94 +/- 2.13 to 72.79 +/- 1.63 mm Hg under the influence of NaN infusion supplemented with halothane. No dose-response relationship existed between NaN and the intraoperative MAP. A 44% reduction in the measured red cell volume was observed in comparison to a previously studied group of patients who underwent similar surgical procedures under normotensive anesthesia. It is concluded from an extensive review of the literature that the most vulnerable period for serious complications is in the immediate postoperative period. No significant complications or adverse effects were observed in this study. It cannot be emphasized too strongly that the safety of this hypotensive technique lies in constant and careful monitoring of the patient and meticulous attention to all details of anesthetic management.
为准确评估口腔面部矫正手术期间血容量的变化，术前和术后均进行了双标记放射性同位素血容量研究。在两个不同机构进行的研究中，观察到与估计失血量不一致的意外大量红细胞容量（RCV） deficit。低血压全身麻醉用于减少口腔面部矫正手术中失血的预期目的。术前、术中和术后测量了各种生理参数，以评估患者对这种麻醉方法的反应。在输注硝酸钠并补充氟烷的影响下，平均动脉压（MAP）从89.94±2.13降至72.79±1.63 mmHg。硝酸钠与术中MAP之间不存在剂量反应关系。与先前在正常血压麻醉下接受类似手术的患者组相比，观察到测量的红细胞容量减少了44%。通过广泛的文献综述得出结论，严重并发症的最危险期是术后即刻。本研究未观察到明显的并发症或不良反应。必须着重强调的是，这种低血压技术的安全性在于对患者进行持续且仔细的监测以及对麻醉管理的所有细节予以精心关注。
