A Clinical Evaluation of Hypotensive Anesthesia for Maxillofacial Reconstruction and Plastic Sugery / 대한마취과학회지

ABSTRACT

Deliberate hypotension reduces bleeding into a wound, thereby providing the surgeon with both better visilibility and technical freedom for a more definitive dissection and minimizes the need for blood transfusion, thereby reducing the risks of transfusion reasctions, hepatitis and acquired immunodeficiency syndrome (AIDS). In this study we evaluated the hypotensive anesthesia induced by sodium nitroprusside for maxillofacial reconstruction and plastic surgery performed at Seoul Paik Hospital from March 19S8 to February 1989 The results of our study were as follows 1) Halothane and enflurane were used as the main anesthetics in 77 and 6 cases respectively. Nitroprusside was used for inducing hypotension and the mean amount infused was 10.5+/-7.7 mg. 2) The mean arterial pressure at 30min after inducing hypotension was 64.5+/-5.3mmHg. 3) The mean blood loss was 736.9+/-394.5ml and the mean amount of transfused blood was 497.1+/-451.1 ml. 4) The intraoperative arterial blood gas analysis shoueds no significant abnormality. 5) There were no significant perioperative and postoperative complications due to induced hypotension itself. In conclusion, the technique of using induced hypotension with inhalation anesthesia supplemented by nitroprusside under 10 head up position is relatively safe and useful one to use in performing maxillofacial reconstruction and plastic sugery.