Kim Cheul-Hong, Yoon Ji-Young, Yun Giyoung, Kim Hee Young, Kim Eun-Jung
Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Dental and Life Science Institute, Pusan National University, Yangsan, Republic of Korea.
Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Republic of Korea.
J Dent Anesth Pain Med. 2025 Feb;25(1):23-32. doi: 10.17245/jdapm.2025.25.1.23. Epub 2025 Jan 22.
Intraoperative hemoglobin (Hb) monitoring is critical for ensuring patient safety during bimaxillary orthognathic surgery. Intraoperative Hb monitoring performed using portable devices with arterial blood samples is invasive, is time-consuming, and lacks the ability to provide real-time information. This retrospective study investigated the correlation between continuous and real-time total Hb (SpHb) using a Masimo Radical 7 device and Hb levels derived by portable devices during bimaxillary orthognathic surgery.
Patients who underwent elective bimaxillary orthognathic surgery were enrolled. The correlation between SpHb and laboratory Hb (Lab-Hb) was evaluated immediately after the induction of anesthesia (T1) and at surgical closure (T2) and compared with postoperative Hb.
Eighty-eight patients were included. The correlation coefficients between SpHb and Lab-Hb were 0.795 and 0.859 at T1 and T2, respectively. The correlation coefficient between Lab-Hb at T2 and postoperative Hb was 0.918. A Bland-Altman analysis of the Lab-Hb at T2 and postoperative Hb showed a mean bias of 0.49.
In conclusion, here we demonstrated acceptable accuracy of the SpHb measured by the Masimo Radical 7 device during bimaxillary orthognathic surgery. However, SpHb is valuable as an adjunct value to Lab-Hb and a substitute for Hb monitoring due to its wide limits of agreement. These findings suggest that SpHb can help guide the timing of invasive blood sampling for Hb measurements, which may facilitate earlier intervention and treatment.
术中血红蛋白（Hb）监测对于确保双颌正颌手术期间的患者安全至关重要。使用便携式设备采集动脉血样进行术中Hb监测具有侵入性、耗时，且无法提供实时信息。这项回顾性研究调查了在双颌正颌手术期间，使用Masimo Radical 7设备测量的连续实时总血红蛋白（SpHb）与便携式设备测得的Hb水平之间的相关性。
纳入接受择期双颌正颌手术的患者。在麻醉诱导后即刻（T1）和手术结束时（T2）评估SpHb与实验室血红蛋白（Lab-Hb）之间的相关性，并与术后Hb进行比较。
纳入88例患者。T1和T2时SpHb与Lab-Hb之间的相关系数分别为0.795和0.859。T2时的Lab-Hb与术后Hb之间的相关系数为0.918。对T2时的Lab-Hb和术后Hb进行Bland-Altman分析，平均偏差为0.49。
总之，我们在此证明了在双颌正颌手术期间，Masimo Radical 7设备测量的SpHb具有可接受的准确性。然而，由于其一致性界限较宽，SpHb作为Lab-Hb的辅助值以及Hb监测的替代方法具有一定价值。这些发现表明，SpHb有助于指导侵入性血样采集以测量Hb的时机，这可能有助于更早地进行干预和治疗。
