Department of Oral and Maxillofacial Surgery, School of Dentistry, Marmara University, Istanbul, Turkey.
J Craniomaxillofac Surg. 2010 Jul;38(5):345-9. doi: 10.1016/j.jcms.2009.10.012. Epub 2009 Nov 12.
To evaluate the role of induced hypotension during maxillary downfracture osteotomy on the requirement for blood transfusion, duration of operation and induced anaemia in bimaxillary surgery.
45 young orthognathic patients were operated under hypotensive anaesthesia between 2004 and 2006. Operations were LeFort I osteotomies (n=45), bilateral sagittal split osteotomies (BSSO) (n=42), segmental osteotomies (n=3), tongue reduction (n=1), genioplasties (n=15), digastric myotomies (n=2), and bone grafts were the supplementary procedures. Pre-postoperative haemograms, intraoperative blood loss, and duration of operations were the studied parameters. Statistical analysis was performed using SPSS 11.5 for Windows.
None of the patients received a blood transfusion. Mean blood loss was 377+/-111.2mL with the range of 180mL to the maximum of 625mL. Mean duration was 267.1+/-61.2min with minimum of 180min and maximum of 400min. Mean preop Hb level was 14+/-1.9g/dL with the range from 10.3g/dL to a maximum of 17.2g/dL. Mean postop Hb level was 11.8+/-2g/dL with a range of 8.2-16.2g/dL levels. Preop erythrocyte counts were 435.3+/-18.2 and 416.4+/-16.1 (x104/mcL) on the first postop day.
Transfusion in bimaxillary orthognathic surgery could be prevented by induction of hypotension during maxillary downfracture.
评估在双颌正颌手术中，上颌骨下降骨折切开术中诱导性低血压对输血需求、手术持续时间和诱导性贫血的作用。
2004 年至 2006 年间，45 名年轻正颌患者在低血压麻醉下接受手术。手术为 LeFort I 截骨术（n=45）、双侧矢状劈开截骨术（BSSO）（n=42）、节段性截骨术（n=3）、舌骨缩小术（n=1）、下颌骨整形术（n=15）、二腹肌切开术（n=2），骨移植为补充手术。研究参数包括术前术后血液学参数、术中失血量和手术持续时间。统计分析采用 SPSS 11.5 for Windows 进行。
无患者接受输血。平均失血量为 377+/-111.2mL，范围为 180mL 至 625mL 最大值。平均手术时间为 267.1+/-61.2min，最短为 180min，最长为 400min。平均术前 Hb 水平为 14+/-1.9g/dL，范围为 10.3g/dL 至 17.2g/dL 最大值。平均术后 Hb 水平为 11.8+/-2g/dL，范围为 8.2-16.2g/dL。术后第一天的红细胞计数分别为 435.3+/-18.2 和 416.4+/-16.1（x104/mcL）。
通过在上颌骨下降骨折切开术中诱导性低血压，可以防止双颌正颌手术中的输血。
