Thomas A A, Rittersma J
J Maxillofac Surg. 1978 Aug;6(3):204-6. doi: 10.1016/s0301-0503(78)80090-3.
The anaesthetic experiences and problems have been analysed, based on 100 orthognathic operations. The material includes all kinds of operations; operating time was about 4 hours, except for 8 very extensive procedures, lasting 6--7 hours. The importance of adequate premedication is emphasized. The use of nasal drops for decongestion is especially highly recommended for the prevention of bleeding during nasal intubation. An armoured nasal tube is always used; however, special care must be taken to detect leaks on the cuff. On four occasions the tubes had to be changed because of leaks in the cuff. The most annoying complication was tachycardia, due to: insufficient premedication, insufficient analgesics during operation, or the use of hypotensive drugs. Blood loss was clearly diminished by controlled hypotension. Postoperative vomiting was prevented by the use of a nasogastric tube for the first 6--8 hours. Major complications were not encountered.
基于100例正颌手术，对麻醉经验和问题进行了分析。资料包括各种手术；手术时间约4小时，但有8例非常复杂的手术持续了6至7小时。强调了充分术前用药的重要性。特别强烈推荐使用滴鼻剂减轻充血，以预防鼻插管期间出血。始终使用带金属丝的鼻导管；然而，必须特别注意检测套囊是否漏气。有4次因套囊漏气不得不更换导管。最恼人的并发症是心动过速，原因是：术前用药不足、术中镇痛不足或使用了降压药物。控制性低血压明显减少了失血量。术后前6至8小时使用鼻胃管预防了呕吐。未出现重大并发症。
