Induced Hypotension in Orthognathic Surgery: A Comparative Study of 2 Pharmacological Protocols
Purpose
The objective of this comparative study was to report on the use of 2 different pharmaceutical protocols involving 2 different anesthetic techniques (IV and balanced) to induce hypotension in patients submitted to orthognathic surgery by assessing the patients' intra- and postoperative physiologic response and hemodynamic stability.
Patients and Methods
Twenty ASA I patients, between 17 and 44 years of age who had dental and skeletal deformities were subdivided into 2 groups: group I (clonidine associated to remifentanil), and group II (dexmedetomidine associated to isoflurane), in addition, other drugs were common to both groups. The following responses were assessed: arterial blood pressure, heart rate, temperature during intra- and postoperative periods, incidence of nausea and vomiting, postoperative pain, awakening time, extubation time, and postanesthetic recovery time.
Results
The results of the study using Repeated Measures Test statistical analysis showed that there were no significant differences between the 2 groups in respect to physiologic responses or surgery time.
Conclusion
Both protocols tried in this study proved to be effective and safe, and they seem to be interesting alternatives in longer orthognathic surgeries with the expectation of an important blood loss. The choice for either protocol should be based on the inherent risks involved in their use and their cost-benefit ratio.
⁎Former Resident, Department of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
†Professor, Department of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
‡Professor, Department of Oral and Maxillofacial Surgery, State University of Maringá, Maringá, Brazil
§Professor, Department of Oral and Maxillofacial Surgery, State University of Maringá, Maringá, Brazil
¶Professor, Department of Oral and Maxillofacial Surgery, State University of Maringá, Maringá, Brazil
#Professor, Department of Bio-statistics, State University of Maringá, Maringá, Brazil
⁎⁎Doctor Anesthetist and Medical Residence Preceptor in Anesthesiology, Santa Casa de Maringá's Hospital, Maringá, Brazil
Address correspondence and reprint requests to Dr Farah: R. Francisco Glicério, 1419–Apto 504–Zona 07–CEP 87030-050, Maringá, PR Brazil
ABSTRACT