Evaluation of hemorrhage depressors on blood loss during orthognathic surgery: a retrospective study.
OBJECTIVE
Correction of dentofacial deformities by orthognathic surgery may cause significant bleeding and therefore hypotensive anesthesia is often used to reduce the blood loss. The main objective of the present clinical study was to determine whether the addition of hemorrhage depressors to other medication during orthognathic surgery would further reduce the blood loss.


METHODS
Thirty patients, consecutively operated on with standardized Le Fort I osteotomies in 1998 (n = 15, control group) and 1999 (n = 15, treatment group), were included in the study. Both groups received hypotension anesthesia during surgery and the treatment group received additional hemorrhage depressors; tranexamic acid and desmopressin.


RESULTS
The mean blood loss was 740 +/- 410 mL (11.3 mL/kg) in the control group and 400 +/- 210 mL (5.7 mL/kg) in the treatment group. The results showed a statistically significant reduction of blood loss in the treatment group (P <.01).


CONCLUSIONS
This study shows that blood loss during orthognathic surgery under hypotensive anesthesia can be significantly reduced when a combination of tranexamic acid and desmopressin is added.
Zellin
Göran
G
Department of Oral and Maxillofacial Surgery, Sahlgrenska Academy, Göteborg University, Sweden.
Rasmusson
Lars
L
Pålsson
Jan
J
Kahnberg
K-E
KE
D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003131:Combined Modality Therapy / Q000379:methods; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007023:Hypotension, Controlled; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000517:prevention & control; D019340:Osteotomy, Le Fort / Q000379:methods*; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000627:therapeutic use
D006490:Hemostatics; D014148:Tranexamic Acid; D003894:Deamino Arginine Vasopressin