The effect of hypotensive anesthesia on blood loss and operative time during Le Fort I osteotomies.
OBJECTIVE
The purpose of this prospective study was to compare the quality of the surgical field, blood loss, and operative time with either hypotensive or normotensive anesthesia during Le Fort I osteotomies.


METHODS
Twenty-three patients were randomized into normotensive or hypotensive anesthesia treatment groups. The quality of the surgical field was assessed intraoperatively by direct observation and again postoperatively using video imaging. A standardized rating scale was applied at specific intervals by surgeons blinded to the anesthetic technique. The surgical time was measured on the videotape, and blood loss was measured by volumetric and gravimetric techniques.


RESULTS
There was a statistically significant correlation (P < .0001) between the surgeon's perception of the quality of the surgical field and the blood pressure. There was also a statistically significant reduction (P < .01) in blood loss when using hypotensive anesthesia. However, there was no statistically significant reduction (P = .44) in operative time when using hypotensive anesthesia.


CONCLUSIONS
It was concluded that hypotensive anesthesia is valuable in reducing blood loss and improving the quality of the surgical field during Le Fort I osteotomies, allowing for easier, more deliberate, and careful dissection. However, it does not reduce operative time.
Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada. drdolman@hotmail.com
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Bentley
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English
D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D016009:Chi-Square Distribution; D017050:Episode of Care; D005260:Female; D006801:Humans; D007023:Hypotension, Controlled; D008297:Male; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000517:prevention & control; D019340:Osteotomy, Le Fort; D011446:Prospective Studies; D011787:Quality of Health Care; D016037:Single-Blind Method; D013997:Time Factors