The role of controlled hypotension upon transfusion requirement during maxillary downfracture in double-jaw surgery

Abstract

Introduction: To evaluate the role of induced hypotension during maxillary downfracture osteotomy on the requirement for blood transfusion, duration of operation and induced anaemia in bimaxillary surgery.

Material and methods: 45 young orthognathic patients were operated under hypotensive anaesthesia between 2004 and 2006. Operations were LeFort I osteotomies (n=45), bilateral sagittal split osteotomies (BSSO) (n=42), segmental osteotomies (n=3), tongue reduction (n=1), genioplasties (n=15), digastric myotomies (n=2), and bone grafts were the supplementary procedures. Pre-postoperative haemograms, intraoperative blood loss, and duration of operations were the studied parameters. Statistical analysis was performed using SPSS 11.5 for Windows.

Results: None of the patients received a blood transfusion. Mean blood loss was 377+/-111.2mL with the range of 180mL to the maximum of 625mL. Mean duration was 267.1+/-61.2min with minimum of 180min and maximum of 400min. Mean preop Hb level was 14+/-1.9g/dL with the range from 10.3g/dL to a maximum of 17.2g/dL. Mean postop Hb level was 11.8+/-2g/dL with a range of 8.2-16.2g/dL levels. Preop erythrocyte counts were 435.3+/-18.2 and 416.4+/-16.1 (x104/mcL) on the first postop day.

Conclusion: Transfusion in bimaxillary orthognathic surgery could be prevented by induction of hypotension during maxillary downfracture.