Reduced blood loss with hemodynamic stability during controlled hypotensive anesthesia for LeFort I maxillary osteotomy using high-dose fentanyl: a retrospective study.

The hazards of blood transfusion today include the transmission of serious and sometimes life-threatening viral illnesses such as hepatitis and acquired immunodeficiency syndrome. The anesthesia provider can reduce the need for operative transfusion by intentionally lowering a patient's blood pressure during surgery. Two techniques for controlled hypotensive anesthesia (CHA) were compared retrospectively to examine differences in surgical blood loss for an operation that has the potential for high volume blood loss, maxillary osteotomy. The intravenous use of 30 micrograms/kg fentanyl was compared with vasodilators in CHA, without compromising the quality or safety of the surgical procedure. The use of fentanyl as the independent variable significantly reduced the estimated blood loss for comparable populations undergoing similar operations when compared with intravenous vasodilators, because of it's ability to stabilize the hemodynamic responses to surgical stress.