Hipotensão induzida em cirurgia ortognatica : estudo comparativo de dois protocolos farmacologicos / Induced hypotension in orthognathic surgery : a comparative study of two pharmacological protocols

AUTOR(ES)

Gustavo Jacobucci Farah

DATA DE PUBLICAÇÃO

2007

RESUMO

Induced or controlled hypotension in Oral and Maxillofacial Surgery is a method by which blood pressure is reduced in a safe and deliberate way. This invasive type of surgery and has a high probability of intraoperative blood loss. Thus, certain anesthetic and surgical procedures are necessary to avoid complications during surgery. Induced or controlled hypotension techniques are used to reduce surgery time and intraoperative blood loss, and to provide a better operating environment. The purpose of this study was to compare two induced hypotension pharmacological protocols in patients undergoing orthognathic surgery and to avaluate physiological response and haemodynamic stability in the intra and postoperative periods. Twenty patients (ASA I), between the ages of 17 and 44, who had skeletal and dental deformities were divided into two groups: in group I, clonidine associated to remifentanil, was used as the hypotensive medication; and in group II, dexmedetomidina associated to isoflurane was used, in addition to other drugs that were used in both groups. Blood pressure, heart frequency, temperature intra and postoperative, incidence of nausea and vomiting, postoperative pain and waking, extubation and postanesthetic recovery times were analyzed. Through statistical analysis using the Repeated Measures test, it was verified that there were no significant differences between the groups regarding physiological responses or surgery time. It was concluded that induced hypotension is a technique that can be adopted in orthognathic surgeries of long duration with the expectation of great blood loss. Furthermore, both of the protocols studied were efficient and safe for use in hypotensive anesthesia, and should be chosen based on the risk and cost to benefit ratio

ASSUNTO(S)

pressão arterial blood pressure dexmedetomidina dexmedetomidine clonidina clonidine

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