Evaluation of hemorrhage depressors on blood loss during orthognathic surgery: a retrospective study

• Published in: Journal of oral and maxillofacial surgery Vol. 62; no. 6; pp. 662 - 666
• Main Authors: Zellin, Göran, Rasmusson, Lars, Pålsson, Jan, Kahnberg, K.-E
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2004; Elsevier
• Subjects: Adolescent; Adult; Anesthesia; Anesthesia, Dental - methods; Biological and medical sciences; Blood Loss; Blood Loss, Surgical - prevention & control; Combination; Combined Modality Therapy; Combined Modality Therapy - methods; Controlled; Deamino Arginine Vasopressin; Deamino Arginine Vasopressin - therapeutic use; Dental; Dentistry; Drug Therapy; Drug Therapy, Combination; Female; Hemostatics; Hemostatics - therapeutic use; Humans; Hypotension; Hypotension, Controlled; Le Fort; Male; Maxilla; Maxilla - surgery; Medical sciences; methods; Middle Aged; Odontologi; Oral Hemorrhage; Oral Hemorrhage - prevention & control; Osteotomy; Osteotomy, Le Fort - methods; Otorhinolaryngology. Stomatology; prevention & control; Retrospective Studies; surgery; Surgical; therapeutic use; Tranexamic Acid; Tranexamic Acid - therapeutic use; Evaluation; Treatment; Stomatology; Surgery; Blood loss; Hemorrhage; Retrospective
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/j.joms.2004.02.001

Correction of dentofacial deformities by orthognathic surgery may cause significant bleeding and therefore hypotensive anesthesia is often used to reduce the blood loss. The main objective of the present clinical study was to determine whether the addition of hemorrhage depressors to other medication during orthognathic surgery would further reduce the blood loss.
Thirty patients, consecutively operated on with standardized Le Fort I osteotomies in 1998 (n = 15, control group) and 1999 (n = 15, treatment group), were included in the study. Both groups received hypotension anesthesia during surgery and the treatment group received additional hemorrhage depressors; tranexamic acid and desmopressin.
The mean blood loss was 740 ± 410 mL (11.3 mL/kg) in the control group and 400 ± 210 mL (5.7 mL/kg) in the treatment group. The results showed a statistically significant reduction of blood loss in the treatment group (
P < .01).
This study shows that blood loss during orthognathic surgery under hypotensive anesthesia can be significantly reduced when a combination of tranexamic acid and desmopressin is added.