title: Remifentanil Reduces Blood Loss During Orthognathic Surgery.
abstract: Remifentanil is reported to reduce oral tissue blood flow. We performed a retrospective investigation using logistic regression analysis of anesthesia records to investigate whether the use of remifentanil infusion in a balanced anesthesia technique was useful as a primary technique to reduce blood loss during orthognathic surgery. Subjects were 80 patients who underwent Le Fort I osteotomy and sagittal split ramus osteotomy of the mandible. The variables included gender, age, weight, type of maintenance anesthetic, type and dose or infusion rate of opioid, mean systolic blood pressure (SBP-mean), coefficient of variation of systolic blood pressure (CVSBP) during surgery, mean heart rate (HR-mean), duration of surgery, total blood loss, volume of infusion used, amount of local anesthetic used, body temperature, and urine output. Gender, type of maintenance anesthetic, type of opioid, SBP-mean, CVSBP, HR-mean, and duration of surgery were used as candidates for independent variables. Logistic regression analysis was performed for the selected independent variables with the total blood loss as the dependent variable. The factors associated with the reduction of blood loss were the use of remifentanil (odds ratio, 3.112; 95% CI, 1.166-8.307; P = .023) and smaller CVSBP (odds ratio, 2.747; 95% CI, 1.07-7.053; P = .036). Use of remifentanil and smaller CVSBP were associated with a reduction of blood loss during orthognathic surgery.
authors.affiliation: Senior Assistant Professor, Department of Dental Anesthesiology, Tokyo Dental College, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuura
authors.affiliation: Research Fellow, Department of Dental Anesthesiology, Tokyo Dental College, Japan.
authors.forename: Taiki
authors.initials: T
authors.lastname: Okamura
authors.affiliation: Assistant Professor, Department of Dental Anesthesiology, Tokyo Dental College, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Ide
authors.affiliation: Professor and Chairman, Department of Dental Anesthesiology, Tokyo Dental College, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ichinohe
mesh_terms: D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001794:Blood Pressure; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D016015:Logistic Models; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D016017:Odds Ratio; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects*; D010027:Osteotomy / Q000009:adverse effects*; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects; D000077208:Remifentanil; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil
keywords: Blood loss; General anesthesia; Logistic regression analysis; Orthognathic surgery; Remifentanil