scholarly journals Limiting blood loss in orthognathic surgery with Esmolol as a hypotensive agent

2017 ◽  
Vol 2 (2) ◽  
pp. 86
Author(s):  
Sailesh Kumar Mukul ◽  
Amit Kumar ◽  
Ejaz Ahmad Mokhtar ◽  
Shweta Pandey
Keyword(s):  
Blood Loss ◽  
Surgical Procedures ◽  
Orthognathic Surgery ◽  
Induced Hypotension ◽  
Hypotensive Anesthesia ◽  
Group I ◽  
Anesthesia Group ◽  
Duration Of Surgery ◽  
Group 2 ◽  
Fast Acting

Orthognathic surgery may be complicated by difficulty in achieving hemostasis because unlike soft tissue, the vessels traversing bone cannot be identified and isolated before osteotomy. In this study we evaluated the amount of blood loss and duration of surgery under deliberate hypotensive anesthesia in comparison to amount of blood loss and duration of surgery under normotensive anesthesia on patients undergoing orthognathic surgical procedures. A total of 16 cases undergoing orthognathic surgery were included in this clinical study.Patients were randomly grouped under normotensive (group I) or hypotensive group (group 2). Patients in hypotensive anesthesia group were given Esmolol to maintain mean arterial pressure in the range of 70-80 mm of Hg till osteotomy segments were fixed. There was more than 40% reduction in blood loss in orthognathic surgical procedures when induced hypotension was used, but there was not statistically significant (p=0.91) reduction in the operative time. Based on surgeons and anesthetist’s assessment fast acting agents like Esmolol can be used intraoperatively to induce hypotension as and when required.  

scholarly journals The Effects of Oral Atenolol or Enalapril Premedication on Blood Loss and Hypotensive Anesthesia in Orthognathic Surgery

2015 ◽  
Vol 56 (4) ◽  
pp. 1114 ◽  
Author(s):  
Na Young Kim ◽  
Young-Chul Yoo ◽  
Duk-Hee Chun ◽  
Hye Mi Lee ◽  
Young-Soo Jung ◽  
...  
Keyword(s):  
Blood Loss ◽  
Orthognathic Surgery ◽  
Hypotensive Anesthesia

Assessment of the Related Factors of Blood Loss and Blood Ingredients Among Patients Under Hypotensive Anesthesia in Orthognathic Surgery

2011 ◽  
Vol 22 (5) ◽  
pp. 1594-1597 ◽  
Author(s):  
Chun-Ming Chen ◽  
Steven Sheng-Tsung Lai ◽  
Kun-Jung Hsu ◽  
Huey-Er Lee ◽  
Hsiao-Ling Huang
Keyword(s):  
Blood Loss ◽  
Orthognathic Surgery ◽  
Related Factors ◽  
Hypotensive Anesthesia

scholarly journals Topical anesthesia versus peribulbar anesthesia in phacoemulsification cataract surgery and intraocular lens implantation

2020 ◽  
Vol 5 (2) ◽  
pp. 100-103
Author(s):  
Incaf Elboukhani ◽  
◽  
Choaib Essadouni ◽  
Adil Mchachi ◽  
Leila Benhmidoune ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cataract Surgery ◽  
Topical Anesthesia ◽  
Advantages And Disadvantages ◽  
Anesthesia Group ◽  
Duration Of Surgery ◽  
Peribulbar Anesthesia ◽  
Group 2 ◽  
Phacoemulsification Cataract Surgery ◽  
Group 1

Topical anesthesia during phacoemulsification cataract surgery has become the best choice for ophthalmologists, which broadens the indications for surgery, and eliminates the risk of peribulbar injections. The aim of our study is to assess the advantages and disadvantages, the efficacy and the tolerance of this protocol. Prospective study extending from January 2018 to December 2019, including 116 patients operated for cataracts under topical anesthesia (group 1), and 179 patients under peribulbar anesthesia (group 2). All patients were operated by phacoemulsification. The patients evaluated their pain on a visual analog scale graduated from 1 to 10. The two groups were comparable in age, gender and history of high blood pressure. All patients received premedication before surgery (Atarax). It was the first eye operated for cataracts in 79 patients in group 1 and 75 patients in group 2. The two groups did not differ significantly in systolic blood pressure rate (p= 0,36), pain score (p=0.54), duration of surgery (p=0.52), anaesthesia-related intraoperative difficulties (p=0.17), or intraoperative surgical complication rate (p=0.49) or blood oxygen saturation (p=0.74). However, in the peribulbar groups, better patient and surgeon satisfaction scores were obtained (P < .005).

scholarly journals Single- and multistage surgical treatment of patients with degenerative sagittal imbalance

2021 ◽  
Vol 18 (2) ◽  
pp. 44-53
Author(s):  
E. S. Baikov ◽  
A. V. Peleganchuk ◽  
A. J. Sanginov ◽  
O. N. Leonova ◽  
A. V. Krutko
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Charlson Comorbidity Index ◽  
Sagittal Imbalance ◽  
Group I ◽  
Duration Of Surgery ◽  
Comorbidity Index ◽  
Group Ii ◽  
Clinical And Radiological Results ◽  
High Charlson Comorbidity Index

Objective. To analyze the nearest clinical and radiological results of simultaneous and staged surgical treatment of patients with degenerative sagittal imbalance.Material and Methods. Retrospective monocentric cohort study included analysis of data from 54 patients who underwent simultaneous combination of surgical methods with obligatory corrective anterior fusion at the L4–L5 or at L4–L5 and L5–S1 levels (Group I, n = 27) or similar surgical intervention though divided into stages with an interval of 5 days or more (Group II, n = 27). A comparison of clinical, radiological, and operational data during inpatient treatment was carried out.Results. The duration of surgery was 410.93 ± 76.34 minutes in Group I and 594.63 ± 102.61 minutes in Group II (p = 0.000001); the  blood loss was 926.67 ± 378.63 ml versus 1345.19 ± 522.97 ml, respectively (p = 0.001575). Postoperative clinical and radiological parameters did not differ between groups: VAS back (p = 0.248647), VAS leg (p = 0.196140), PT (p = 0.115965), SVA (p = 0.208449), LL (p = 0.023654), LDI (p = 0.931646), PI-LL (p = 0.693045), GAP (p = 0.823504), and restoration of the ideal Russoly type (p = 0.111476). The incidence of perioperative complications in groups was comparable: 17 (62.96 %) in Group I and 15 (55.56 %) in Group II (p = 0.583171). Patients with a high Charlson comorbidity index had a significantly higher incidence of complications (p = 0.023471). The index of surgical invasiveness in Group I had a significant correlation with the total number of complications (r = 0.421332).Conclusion. Clinical and radiological results and the incidence of complications are comparable between single- and multistage approaches to correct sagittal balance disorders. In staged treatment, the total duration of surgery and the volume of blood loss are significantly higher. With a high Charlson comorbidity index and Mirza surgical invasiveness index, a multistage approach to the treatment of patients with sagittal imbalance is preferred.

scholarly journals Assessment of Intraoperative Blood Loss during Oral and Maxillofacial Surgical Procedures in a Nigerian Tertiary Health Care Center

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Babatunde O. Akinbami ◽  
Bisola Onajin-Obembe
Keyword(s):  
Blood Loss ◽  
Surgical Procedures ◽  
Significant Relationship ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Care Center ◽  
Mean Value ◽  
Health Care Center ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Background. Reports on estimated amount of blood loss in maxillofacial surgical procedures will guide clinicians through units of blood required for each procedure. The aim of the study was to assess the amount of blood loss and duration of surgery. Methods. All cases of maxillofacial surgical procedures done under GA in the MFU theatre, from January 2007 to December 2013, were included in the study. Pre- and postoperative haematocrit values, number of units of whole blood requested and used, amount of blood loss, and duration of surgery were recorded. Results. 139 patients were analyzed, of which 75 (54.0%) were males and 64 (46.0%) were females. Fifty-six (40.3%) cases involved soft tissues. Eighty-three cases involved hard tissues. Age range was 2 months to 78 years; mean ± (SD) was 21.3±(18.5) years. Isolated unilateral cleft lip had the lowest mean value of estimated blood loss of 10.4±10.8 mLs and also the lowest duration of surgery of 58 (76) minutes. There was no significant relationship between both parameters for cleft lip. Fractures of the mandible had mean blood loss of 352 mLs and duration was 175 min. Conclusion. In this study, there was significant relationship between estimated blood loss and duration of surgery for mandibular and zygomatic complex fractures.

Bilateral cochlear implantation in children: simultaneously or in consecutive sessions?

2021 ◽  
pp. 1-5
Author(s):  
A Dalgic ◽  
G Atsal ◽  
O Yildirim ◽  
D T Edizer ◽  
MB Özay ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Cochlear Implantation ◽  
Operation Time ◽  
Radiological Findings ◽  
Total Operation Time ◽  
Duration Of Surgery ◽  
Second Surgery ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Objective This study aimed to evaluate and compare cases of simultaneous and consecutive bilateral cochlear implantation from the perspective of the duration of anaesthesia, surgical complications and hospitalisation. Method Fifty patients with simultaneous bilateral cochlear implantation (group 1) and 47 patients with consecutive bilateral cochlear implantation (group 2) were included in this study. The two groups were compared in terms of the duration of anaesthesia, the duration of surgery, radiological findings, the complications and the post-operative hospitalisation time. Results Group 1 had a significantly shorter operation time than group 2 (p < 0.01). The mean total operation time was 189 minutes in group 1. In group 2, the mean operation times for the first and second surgery were 134 minutes and 136 minutes, respectively, and the total operation time for both surgical procedures in group 2 was 270 minutes. The duration of post-operative hospitalisation of the patients in group 1 was significantly shorter than the total post-operative hospitalisation after both operations for the patients in group 2 (p < 0.01). Conclusion In conclusion, if there is no anatomical problem that may lead to a prolonged operation time or any risk regarding anaesthesia, simultaneous bilateral cochlear implantation can be performed safely.

scholarly journals Epidural and general anesthesia versus general anesthesia in radical prostatectomy

Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 772 ◽  
Author(s):  
Renatas Tikuišis ◽  
Povilas Miliauskas ◽  
Narimantas Samalavičius ◽  
Aleksas Žurauskas ◽  
Algimantas Sruogis
Keyword(s):  
Radical Prostatectomy ◽  
Blood Loss ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Allogeneic Blood ◽  
Blood Transfusions ◽  
Intraoperative Blood Loss ◽  
Induced Hypotension ◽  
General Anesthesia Group ◽  
Anesthesia Group

Induced hypotension with epidural anesthesia influences the intraoperative blood loss in prostate cancer patients undergoing radical prostatectomy. The aim of this study was to evaluate intraoperative blood loss and need of blood transfusions in patients who underwent radical prostatectomy under epidural/general anesthesia and general anesthesia. Two groups were selected: epidural/general anesthesia group (study group, 27 patients) received epidural anesthesia in association with general anesthesia, and general anesthesia group (control group, 27 patients) received general anesthesia alone. Epidural/general anesthesia was performed using 0.5% solution of bupivacaine and maintained by volatile anesthetic sevoflurane. General anesthesia was performed with endotracheal ventilation using sevoflurane and intravenous fentanyl. The present study showed that the mean blood loss in epidural/general anesthesia group was significantly lower in comparison with that of general anesthesia group (740±210 mL versus 1150±290 mL, P<0.001). In addition, less allogeneic blood was transfused in epidural/general anesthesia group: 0.19 blood units transfused versus 0.52 blood units in general anesthesia group (P=0.007). Our study proved that induced hypotension with epidural/general anesthesia reduced intraoperative blood loss and need of allogeneic blood transfusions in cancer patient undergoing open radical prostatectomy.

scholarly journals Remifentanil Reduces Blood Loss During Orthognathic Surgery

2017 ◽  
Vol 64 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Nobuyuki Matsuura ◽  
Taiki Okamura ◽  
Satoko Ide ◽  
Tatsuya Ichinohe
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Blood Loss ◽  
Systolic Blood Pressure ◽  
Odds Ratio ◽  
Orthognathic Surgery ◽  
Total Blood ◽  
Independent Variables ◽  
Duration Of Surgery

Remifentanil is reported to reduce oral tissue blood flow. We performed a retrospective investigation using logistic regression analysis of anesthesia records to investigate whether the use of remifentanil infusion in a balanced anesthesia technique was useful as a primary technique to reduce blood loss during orthognathic surgery. Subjects were 80 patients who underwent Le Fort I osteotomy and sagittal split ramus osteotomy of the mandible. The variables included gender, age, weight, type of maintenance anesthetic, type and dose or infusion rate of opioid, mean systolic blood pressure (SBP-mean), coefficient of variation of systolic blood pressure (CVSBP) during surgery, mean heart rate (HR-mean), duration of surgery, total blood loss, volume of infusion used, amount of local anesthetic used, body temperature, and urine output. Gender, type of maintenance anesthetic, type of opioid, SBP-mean, CVSBP, HR-mean, and duration of surgery were used as candidates for independent variables. Logistic regression analysis was performed for the selected independent variables with the total blood loss as the dependent variable. The factors associated with the reduction of blood loss were the use of remifentanil (odds ratio, 3.112; 95% CI, 1.166–8.307; P = .023) and smaller CVSBP (odds ratio, 2.747; 95% CI, 1.07–7.053; P = .036). Use of remifentanil and smaller CVSBP were associated with a reduction of blood loss during orthognathic surgery.

scholarly journals POST PARTUM HAEMORRHAGE PROPHYLAXIS

2008 ◽  
Vol 15 (03) ◽  
pp. 323-327
Author(s):  
ALIYA ISLAM ◽  
ASIFA SIRAJ ◽  
NADIA ARIF
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Post Partum ◽  
Military Hospital ◽  
Standard Size ◽  
Group I ◽  
Significant Difference ◽  
Post Partum Haemorrhage ◽  
Group Ii ◽  
Group 2

Post partum hemorrhage (PPH) is defined as the loss of greater than 500ml of blood from the genitaltract in the first 24 hours following delivery. PPH occurs in 2-11% of all deliveries. Objective: To compare the efficacyof misoprostol and ergometrine for the prophylaxis of Post Partum Haemorrhage. Design: Prospective study. Setting:Gynaecology and Obstetrics Department Military Hospital Rawalpindi. Period: From 01 July 2006 to 31 Dec 2006.Patients & Methods: A total of 200 patients were recruited in the study, they were divided in two groups, group – I (n100) included those patients who were administered ergometrine intravenously at the time of delivery of head for theprophylaxis of post partum haemorrhage, Group – 2 (n-100) included those patients who were administered Misoprostol800 microgram per rectally just before the start of cesarean section for the same purpose. Blood loss was calculatedobjectively by squeezing the soaked pads and quantifying the amount of clots in a kidney tray of standard size to beequal to 500ml.Results: In group I (n-100) 15 patients had mild PPH blood loss >500ml, out of them 03 had severePPH requiring bimanual message and 02 patients required blood transfusion, in group II( n-100). 08 patients had PPH,blood loss >500 ml, out of them 01 patient required uterine message and none required blood transfusion. Chi-squaretest was applied to compare the efficacy of the two groups, P>0.05 showed no significant difference in the efficacy ofthe two groups but the side effects were obviously less in the Misoprostol group. No patient in group II had GI symptomswhile 36 patient in group I had retching and, vomiting and 03 patients had raised B.P after the administration ofergometrine. Conclusion: Misoprostol administered per rectally has equal efficacy to ergometrine given intravenouslyfor the prophylaxis of post partum haemorrhage but the side effect profile and patient tolerability is better withMisoprostol.

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