Effect of Induced Hypotensive Anesthesia and Normotensive Anesthesia on Intraoperative Blood Loss During Orthognathic Surgery: A Systematic Review.

Background: Orthognathic surgery involves significant bleeding from both soft tissues and bones due to rich blood supply to areas involved. In addition, limited access along with poor visibility and difficulty to isolate or ligate adds to the problem of bleeding during surgery. As a result, to counter drawbacks of intraoperative bleeding, method of induced hypotension stands out. Hypotensive anesthesia is a method through which blood pressure is decreased in a controlled manner. Various studies have been conducted that compared multiple methods to reduce intraoperative blood loss and improve visibility of surgical field. Hence, need for a systematic review to study the effects of hypotensive anesthesia on intraoperative blood loss, duration of the surgery and quality of surgical field. Methods: An electronic search was conducted to cumulate data from PubMed, Google scholar and institutional library from 2000 to 2020. In addition, bibliographies of included studies were hand searched to identify potentially eligible studies to append to the data and reach a conclusion. Results: Comparative study of the data available indicates that controlled hypotension during general anesthesia is safe for young healthy patients undergoing orthognathic surgeries. Conclusion: This information could be of key importance to aid in reducing intraoperative blood loss and which improves the observability of the surgical field; lessen the chances of need for blood transfusion; and eventually shorten the length of stay in hospital. [ABSTRACT FROM AUTHOR]