Assessment of the Related Factors of Blood Loss and Blood Ingredients Among Patients Under Hypotensive Anesthesia in Orthognathic Surgery

Chen, Chun‐Ming; Lai, Steven; Hsu, Kun-Jung; Lee, Huey-Er; Huang, Hsiao‐Ling

doi:10.1097/scs.0b013e31822e5edb

Cited by 13 publications

(13 citation statements)

References 11 publications

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“…Administration of vasoconstrictors like adrenaline or a beta-blocker to the nasal passages, reverse Trendelenburg position, controlled hypotension or steroid therapy were suggested (6). Controlled hypotensive anesthesia is commonly used in several surgical interventions using different techniques (7,8). Volatile anesthetics, sympathetic antagonists, β adrenoreceptor antagonists, calcium channel blockers, opioids, and direct-acting vasodilators have been used to achieve controlled hypotension.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine versus Remifentanil for Controlled Hypotensive

Özcan¹,

Özyurt²,

Saraçoğlu³

et al. 2012

Turk J Anesth Reanim

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Objective: During functional endoscopic sinus surgery (FESS), sufficient control of bleeding is essential in order to increase the visibility in the operative field and reduce the risk of injury to the optic nerve or internal carotid artery. However, choosing the ideal agent is still a controversial topic. The aim of this study is to compare the effects and possible side effects of remifentanil and dexmedetomidine for controlled hypotension in FESS.Methods: Fifty ASA I-II patients, aged between 18-60 years, undergoing elective FESS, were included. Patients were randomly assigned into two groups (n=25) as Group R (remifentanil infusion, 0.25 mcg kg -1 h -1 ) and Group D (dexmedetomidine infusion, 0.2-0.7 mcg kg -1 min -1 ). The duration of anesthesia, surgery and controlled hypotension, total drug doses, dryness of the surgical area, recovery time, side effects, liver and kidney function analyses were recorded. Results:There was no statistically significant difference between the groups in operation time, duration of anesthesia and controlled hypotension time. Group R and D were similar in average SpO 2 , dryness, arterial blood pressure, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN) and creatinine at all measurement times. Heart rate was lower in Group D than Group R at the time of extubation and 5, 10, 15, 20, 30. min after extubation (p<0.05). Mean recovery time of Group D was longer than Group R (p<0.001).Conclusion: Based on the side effect scores, visualisation results of surgical area, liver or renal functions; both dexmedetomidine and remifentanil provided adequate, safe, controlled hypotensive anesthesia. However, dexmedetomidine was associated with significantly longer recovery time period compared with remifentanil.Amaç: Fonksiyonel endoskopik sinüs cerrahisi (FESS) sırasında kanamanın kontrol altına alınması; cerrahi alandaki görüşün artması ile birlikte, optik sinir veya internal karotis arteri gibi önemli yapıların yaralanması riskini de azaltmaktadır. Ancak, bu amaç için ideal ajan seçimi tartışmalı bir konu olmaya devam etmektedir. Bu çalışmada, FESS için kontrollü hipotansiyon uygulamalarında remifentanil ile deksmedetomidinin etkinlikleri ile gelişebilecek yan etkilerinin karşılaştırılmaası amaçlanmıştır.Yöntemler: Çalışmaya, elektif FESS cerrahisi geçirecek, ASA I-II, 18-60 yaş arasında 50 hasta dahil edildi. Hastalar randomize olarak, Grup R (remifentanil infüzyonu, 0,25 mcg kg -1 s -1 , n=25) ve Grup D (deksmedetomidin infüzyonu, 0,2-0,7 mcg kg -1 dk -1 ) olarak iki gruba ayrıldı. İlaç enjeksiyonundan, hedeflenen kan basıncının oluşmasına kadar geçen süre, anestezi ve cerrahi süreleri, verilen toplam ilaç miktarı, cerrahi sahanın kuruluğu, derlenme süresi, yan etkiler ile karaciğer ve böbrek işlevlerine ait değerler kaydedildi. Bulgular: Gruplar arasında anestezi, cerrahi işlem süresi ve kontrollü hipotansiyon süresi bakımından istatistiksel olarak anlamlı fark yoktu. Ortalama periferik oksijen satürasyonu, cerrahi sahanın kuruluğu, kan basınçları,...

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Section: Introductionmentioning

confidence: 99%

Dexmedetomidine versus Remifentanil for Controlled Hypotensive

Özcan¹,

Özyurt²,

Saraçoğlu³

et al. 2012

Turk J Anesth Reanim

View full text Add to dashboard Cite

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“…38 Perhaps the most surprising finding was the lack of evidence regarding the effect of HA on IOB, because this is a well-established hemostatic measure in maxillofacial surgery. 18,40 Choi and Samman 41 reached a similar conclusion in a review from 2008, remarking that HA might prove significant in OS procedures with anticipated high IOB.…”

Section: Discussionmentioning

confidence: 50%

Prevention of Bleeding in Orthognathic Surgery—A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Olsen

Skov

Ingerslev

et al. 2016

Journal of Oral and Maxillofacial Surgery

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“…In that respect, we found that in 22 out of 51 papers, the method of measuring estimated blood loss was missing . In 18 out of 51 papers, the estimated blood loss was measured by deducting the volume of saline used from the total volume in the suction unit and by weighing the sponges [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48], others 10 mL [43]. In 6 out of 51 papers, losses in sponges were not included Table 1.…”

Section: Measurement Of Blood Lossmentioning

confidence: 99%

“…In bimaxillary surgery, Böttger [6] indeed found a linear correlation between calculated blood loss and operation time, but this correlation was weak for 82 bimaxillary procedures: Spearman correlation coefficient r = 0.325. Chen et al [31] found a weak Spearman rank correlation between operation time and blood loss in 30 mandibular surgery patients (IVRO set-back and genioplasty). Rummasak et al [43], in a retrospective review of 208 patients with bimaxillary orthognathic surgery, reported the following correlation between blood loss and operative time: blood loss = (2.64 * operative time) + 82.…”

Section: Duration Of Surgery and Blood Lossmentioning

confidence: 99%

Bloodloss and Transfusion Need in Orthognathic Surgery: Review of Literature

Politis¹,

Agbaje²,

Lambrichts³

2018

EDUJ

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Background: Blood loss during orthognathic surgery has gained renewed interest due to the omission of surgical final splints in bimaxillary surgery, which increased operative time, while orthognathic surgery is increasingly indicated for the treatment of the obstructive sleep apnea syndrome (OSAS). OSAS subjects are usually older with more medical comorbidity which requires blood transfusion. Objective: To review (reported) blood loss and transfusion practice in orthognathic surgery in the literature published between 1976 and 2012 and to compare these data with more recent developments. The relationship between the duration of the surgery and the related blood loss and/or transfusion was examined. Data Sources: The 1976-2012 orthognathic literature was searched to determine the relationship between the duration of the surgery and the related blood loss and/or transfusion. Study Selection: Articles containing clear information on the operation time, blood loss, transfusion, and orthognathic surgery were included. Data Extraction: Information on the operation time, blood loss, transfusion, and orthognathic surgery was extracted. Data Synthesis: Different descriptions of procedures and techniques are grouped together in a concise and coherent way, resulting in a number of categories per label. Using this grouping various targeted questions are exploited and answered.

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Assessment of the Related Factors of Blood Loss and Blood Ingredients Among Patients Under Hypotensive Anesthesia in Orthognathic Surgery

Cited by 13 publications

References 11 publications

Dexmedetomidine versus Remifentanil for Controlled Hypotensive

Dexmedetomidine versus Remifentanil for Controlled Hypotensive

Prevention of Bleeding in Orthognathic Surgery—A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Bloodloss and Transfusion Need in Orthognathic Surgery: Review of Literature

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