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正颌外科手术的综合麻醉管理策略

Comprehensive anaesthesia management strategies for orthognathic surgical procedure.

作者信息

Tapia-Salinas B, Aragón-Niño I, Del-Castillo-Pardo-de-Vera J-L, Cebrián-Carretero J-L

机构信息

Anesthesiology and Reanimation Department La Paz University Hospital Paseo de la Castellana 261 28046 Madrid. Spain

出版信息

Med Oral Patol Oral Cir Bucal. 2025 Jan 1;30(1):e56-e64. doi: 10.4317/medoral.26833.

Abstract

BACKGROUND

Orthognathic surgery is commonly performed to correct malocclusion and facial asymmetry, typically in young and healthy patients. However, it's crucial to recognize that facial deformities can also be features of various syndromes, complicating the surgical and anesthetic management.

MATERIAL AND METHODS

This review examines the key factors influencing anaesthesia management in orthognathic surgery patients. The perioperative care process was analyzed, focusing on the surgical procedure, airway management, and anaesthesia techniques. Additional factors considered include bleeding control, postoperative nausea and vomiting (PONV), antibiotic prophylaxis, analgesia, and deep venous thrombosis (DVT) prevention.

RESULTS

The review highlighted the critical role of comprehensive anaesthesia management in determining the outcomes of orthognathic surgery. Proper airway management, effective bleeding control, and the prevention of PONV and DVT were identified as significant factors in optimizing patient recovery. The use of protocols and a multidisciplinary approach were emphasized as essential in minimizing complications and improving postoperative outcomes.

CONCLUSIONS

Comprehensive and carefully planned anesthesia management is vital for the success of orthognathic surgery. Employing a multidisciplinary approach and adhering to established protocols can enhance patient outcomes and expedite recovery, especially in cases involving complex syndromic patients.

摘要

背景

正颌外科手术通常用于矫正错牙合畸形和面部不对称,患者多为年轻健康人群。然而,必须认识到面部畸形也可能是各种综合征的特征,这会使手术和麻醉管理变得复杂。

材料与方法

本综述探讨了影响正颌外科手术患者麻醉管理的关键因素。分析了围手术期护理过程,重点关注手术操作、气道管理和麻醉技术。还考虑了其他因素,包括出血控制、术后恶心呕吐(PONV)、抗生素预防、镇痛以及深静脉血栓形成(DVT)预防。

结果

该综述强调了全面麻醉管理在决定正颌外科手术结果方面的关键作用。适当的气道管理、有效的出血控制以及预防PONV和DVT被确定为优化患者康复的重要因素。强调使用方案和多学科方法对于最大限度减少并发症和改善术后结果至关重要。

结论

全面且精心规划的麻醉管理对于正颌外科手术的成功至关重要。采用多学科方法并遵循既定方案可改善患者预后并加速康复,尤其是在涉及复杂综合征患者的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e21c/11801685/25f4e00d9fe1/medoral-30-e56-g001.jpg

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