title: Comparison of different hypotensive anaesthesia techniques in orthognathic surgery with regard to intraoperative blood loss, quality of the surgical field, and postoperative nausea and vomiting.
abstract: Sixty-three consecutive patients undergoing bimaxillary surgery between June and August 2015 were included in this study. Twenty-one patients were included in each of three study groups. In group 1, sevoflurane was the sole maintenance anaesthesia agent used; in group 2, propofol was the predominant agent, in addition to a reduced amount of sevoflurane; in group 3, patients received sevoflurane until fixation was completed, at which point it was switched to propofol. The mean intraoperative blood loss (ml) was 707.14±290.74 in group 1, 917.62±380.30 in group 2, and 750.00±331.84 in group 3; the difference between groups 1 and 2 was significant (P=0.047). The mean score for the quality of surgical field assessment was 1.32±0.44 in group 1, 2.04±0.49 in group 2, and 1.45±0.53 in group 3 (P=0.003). The postoperative nausea and vomiting (PONV) rate was 28.6% in group 1, 9.5% in group 2, and 14.3% in group 3 (P=0.343). The quality of the surgical field was significantly better in groups 1 and 3 than in group 2. The average blood loss in group 1 was also significantly less than in group 2. The PONV rates were lower than those reported in other studies.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: S
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of Anaesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: C
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: C-F
authors.initials: CF
authors.lastname: Yao
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Y-A
authors.initials: YA
authors.lastname: Chen
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: uraychen@cgmh.org.tw.
authors.forename: Y-R
authors.initials: YR
authors.lastname: Chen
mesh_terms: D000758:Anesthesia; D018685:Anesthetics, Inhalation; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008738:Methyl Ethers; D056948:Orthognathic Surgical Procedures; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced* / Q000453:epidemiology; D015742:Propofol; D000077149:Sevoflurane; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol
keywords: hypotensive anaesthesia; intraoperative blood loss; orthognathic surgery; postoperative nausea and vomiting; quality of the surgical field