Prasant M C, Kar Sanjay, Rastogi Saurabh, Hada Pratiksha, Ali Fareedi Mukram, Mudhol Anupama
Dean & Head, Department of Oral & Maxillofacial Surgery, RKDF Dental College, Bhopal, Madhya Pradesh, India.
Professor, Department of Oral & Maxillofacial Surgery, Mansarovar Dental College, Hospital & Research Centre, Bhopal, Madhya Pradesh, India.
J Int Oral Health. 2014 Nov-Dec;6(6):18-21.
Oral and maxillofacial surgeons are concern about the intraoperative bleeding because blood supply to face is very generous. Increased blood loss may lead to the need for transfusion of blood and blood products and hence patients are exposed to the risks associated with it. Hence, this study was undertaken to compare whether there is any significant difference in blood loss, surgical field and duration of surgery in patients undergoing maxillofacial surgeries with and without hypotensive anesthesia.
The study was conducted on patients undergoing various maxillofacial surgeries. The patients were randomly divided into two groups, the study group and the control group. In the study group patients, induced hypotension was used in order to maintain systolic pressure of 80-90 mm Hg. In the control group patients, normotensive anesthesia was used. Estimation of blood loss (EBS), quality of the surgical field and duration of surgery was calculated for both groups in three types of surgical procedures. Statistical analysis was performed by using two-tailed Pearson correlation test.
EBS was found to be significantly less in all the surgical procedures carried out under hypotensive anesthesia (P < 0.05). The quality of the surgical field was better in cases with induced hypotension, but there was no significant difference in duration of the procedures with and without induced hypotension.
Our study shows that hypotensive anesthesia can be safely used in almost all maxillofacial surgical procedures with reduced blood loss and improved surgical field.
口腔颌面外科医生关注术中出血情况，因为面部血供非常丰富。失血增加可能导致需要输血及血液制品，从而使患者面临与之相关的风险。因此，本研究旨在比较在接受颌面部手术的患者中，采用与未采用控制性低血压麻醉时，在失血量、手术视野和手术时长方面是否存在显著差异。
本研究针对接受各类颌面部手术的患者开展。患者被随机分为两组，即研究组和对照组。研究组患者采用控制性低血压以维持收缩压在80 - 90 mmHg。对照组患者采用正常血压麻醉。针对两组患者在三种手术术式中分别计算失血量估计值（EBS）、手术视野质量和手术时长。采用双尾Pearson相关性检验进行统计分析。
发现在控制性低血压麻醉下进行的所有手术中，失血量估计值均显著更低（P < 0.05）。控制性低血压病例的手术视野质量更佳，但有无控制性低血压情况下手术时长无显著差异。
我们的研究表明，控制性低血压麻醉几乎可安全用于所有颌面部外科手术，能减少失血量并改善手术视野。
