Rodrigo C
Department of Anesthesiology, University of Hong Kong, Hong Kong, China.
Anesth Prog. 2000 Winter;47(4):151-6.
Orthognathic surgery is carried out to improve facial appearance and/or to improve malocclusion. Usually, patients are young and healthy. However, they may have airway problems. Reinforced silicone low-pressure, high-volume endotracheal tubes and p-xylometazoline (Otrivin) for nasal vasoconstriction reduces problems due to the endotracheal tubes. A head-up position with ventilator and monitoring equipment at the foot end helps the surgeons as well as the surgery. Surgeons may be the cause of endotracheal tube problems. Bleeding is a major problem that may be encountered and is reduced by induced hypotension. During osteotomies, severe bradycardia may occur and may even lead to cardiac arrest. In the early postoperative period, bleeding may be a problem. Later ulceration at the tip of the nose and on the buttocks may be seen if preventive measures are not carried out.
正颌手术旨在改善面部外观和/或矫正错牙合畸形。通常，患者年轻且健康。然而，他们可能存在气道问题。使用强化硅胶低压、大容量气管导管以及用于鼻血管收缩的对羟基麻黄碱（滴鼻净）可减少气管导管相关问题。床头抬高、呼吸机和监测设备置于床尾的体位有助于外科医生操作及手术进行。外科医生可能是气管导管问题的起因。出血是可能遇到的主要问题，可通过诱导性低血压来减少出血。在截骨术中，可能会发生严重心动过缓，甚至可能导致心脏骤停。术后早期，出血可能是个问题。如果不采取预防措施，后期可能会出现鼻尖和臀部溃疡。
