Controlled Hypotension in Maxillofacial Surgery

Haxholdt, B F; Kjaer, Kjell G.; Secher, O

doi:10.1111/j.1399-6576.1958.tb05254.x

Acta Anaesthesiol Scand

1958

DOI: 10.1111/j.1399-6576.1958.tb05254.x

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Controlled Hypotension in Maxillofacial Surgery

B F Haxholdt¹,

Kjell G. Kjaer²,

O Secher³

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2012

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“…70 Proposed benefits include 1) reduced intraoperative blood loss, 2) improved surgical visualization, 3) shortened operative time, and 4) decreased use of and exposure to blood products. 43 The efficacy and safety of this technique have been studied in general plastic surgery, 18,19,23,36,43,72 neurosurgery, 1,3,24,25,28,31,47,48,57,62,74 maxillofacial surgery, 4,7,16,20,21,38,51,54,59,60,73 orthopedic surgery, 2,6,17,35,41,44,46,52,53,67,69 general surgery, 15,33,65 otolaryngology, 8,29,55,56,61,71 bur...…”

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confidence: 99%

Controlled hypotension and blood loss during frontoorbital advancement

Seruya

Oh²,

Rogers³

et al. 2012

PED

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Object Controlled hypotension is routinely used during open repair of craniosynostosis to decrease blood loss, although this benefit is unproven. In this study the authors analyzed the longitudinal relationships between intraoperative mean arterial pressure (MAP) and calculated blood loss (CBL) during frontoorbital advancement (FOA) for craniosynostosis. Methods The authors reviewed the records of infants with craniosynostosis who had undergone primary FOA between 1997 and 2009. Anesthesia records provided preoperative and serial intraoperative MAP. Interval measures of CBL had been determined during the course of the operation. The longitudinal relationships between MAPmean, MAPchange, and CBLchange were assessed over the same time interval and compared between adjacent time intervals to determine the directionality of associations. Results Ninety infants (44 males and 46 females) underwent FOA at a mean age and weight of 10.7 ± 12.9 months and 9.0 ± 7.0 kg, respectively. The average intraoperative MAP was 56.1 ± 4.8 mm Hg, 22.6 ± 12.1% lower than preoperative baseline. A negative correlation was found between CBLchange and MAPmean over the same interval (r = −0.31, p < 0.05), and an inverse relationship was noted between CBLchange of the previous interval and MAPchange of the next interval (r = −0.07, p < 0.05). Finally, there was no significant association between MAPchange of the previous interval and CBLchange of the next interval. Conclusions Calculated blood loss demonstrated a negative correlation with MAP during FOA. Directionality testing indicated that MAP did not affect intraoperative blood loss; instead, blood loss drove changes in MAP. Overall, these findings challenge the benefit of controlled hypotension during open craniofacial repair.

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mentioning

confidence: 99%

Controlled hypotension and blood loss during frontoorbital advancement

Seruya

Oh²,

Rogers³

et al. 2012

PED

View full text Add to dashboard Cite

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Controlled Hypotension in Maxillofacial Surgery

Cited by 1 publication

References 2 publications

Controlled hypotension and blood loss during frontoorbital advancement

Controlled hypotension and blood loss during frontoorbital advancement

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