The effect of hypotensive anesthesia on blood loss and operative time during Le Fort I osteotomies

Purpose: 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. Patients and Methods: Twenty-three patients were randomized into normotensive or hypotensive anesthesia treatment groups. The quality of the surgical held 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. (C) 2000 American Association of Oral and Maxillofacial Surgeons.