The role of controlled hypotension upon transfusion requirement during maxillary downfracture in double-jaw surgery

Introduction: To evaluate the role of induced hypotension during maxillary downfracture osteotomy on the requirement for blood transfusion, duration of operation and induced anaemia in bimaxillary surgery. Material and methods: 45 young orthognathic patients were operated under hypotensive anaesthesia between 2004 and 2006. Operations were LeFort I osteotomies (n = 45), bilateral sagittal split osteotomies (BSSO) (n = 42), segmental osteotomies (n = 3), tongue reduction (n = 1), genioplasties (n = 15), digastric myotomies (n = 2), and bone grafts were the supplementary procedures. Pre-postoperative haemograms, intraoperative blood loss, and duration of operations were the studied parameters. Statistical analysis was performed using SPSS 11.5 for Windows. Results: None of the patients received a blood transfusion. Mean blood loss was 377 ± 111.2 mL with the range of 180 mL to the maximum of 625 mL. Mean duration was 267.1 ± 61.2 min with minimum of 180 min and maximum of 400 min. Mean preop Hb level was 14 ± 1.9 g/dL with the range from 10.3 g/dL to a maximum of 17.2 g/dL. Mean postop Hb level was 11.8 ± 2 g/dL with a range of 8.2-16.2 g/dL levels. Preop erythrocyte counts were 435.3 ± 18.2 and 416.4 ± 16.1 (×104/mcL) on the first postop day. Conclusion: Transfusion in bimaxillary orthognathic surgery could be prevented by induction of hypotension during maxillary downfracture.