Induced hypotensive anesthesia for adolescent orthognathic surgery patients

Purpose: This study compared blood loss, quality of surgical field, and duration of procedure with and without induced hypotensive anesthesia in adolescent orthognathic surgery patients. Patients and Methods: Fifty orthognathic surgery patients were studied in a prospective, randomized, blocked, stratified, and single-blind fashion, All patients underwent either sagittal ramus split osteotomy or Le Fort I osteotomy or genioplasty. One group of patients (n = 25) had induced hypotension; the other group (n = 25) received anesthesia with no attempt to deliberately reduce blood pressure during the operation. The surgeon, unaware of to which group the patient had been assigned, rated the surgical field every 15 minutes. At completion of surgery, three different methods were used to estimate or calculate blood loss. Duration of the procedure was recorded from time of first incision to time of last suture placement. The data were analyzed using ANOVA, chi-squared, and linear regression, where appropriate. Results: Estimated blood loss was significantly less when induced hypotensive anesthesia was used. The surgical field was better, but there was no significant difference in duration of the procedure with induced hypotensive anesthesia. Conclusion: Induced hypotensive anesthesia results in both reduced blood loss and improvement in surgical field.