The Effect of Anesthetic Technique on Recovery After Orthognathic Surgery: A Retrospective Audit

Author:

Chegini Soudeh1,Johnston Kevin D2,Kalantzis Athanasios3,Dhariwal Daljit K4

Affiliation:

1. Foundation Doctor, Heatherwood and Wexham Park Hospitals NHS Foundation Trust

2. Specialist Registrar, Nuffield Department of Anaesthetics

3. Specialist Registrar, Department of Oral and Maxillofacial Surgery

4. Consultant, Department of Oral and Maxillofacial Surgery, The John Radcliffe Hospital, Headley Way, Headington, Oxford, England

Abstract

We audited the recovery characteristics of 51 patients who had undergone orthognathic maxillofacial surgery at a single center. Patients whose anesthesia had been maintained with intravenous propofol and remifentanil (n  =  21) had significantly higher pain scores during the first 4 hours after surgery than those whose anesthesia was maintained with volatile inhalational agents and longer-acting opioids (n  =  30) (P  =  .016). There was a nonsignificant trend towards shorter recovery times in the former group, while there were no differences in early postoperative opioid usage, hemodynamic parameters, or postoperative nausea and vomiting . Given that our data were collected retrospectively and without the ability to control for potential confounders, we interpret the results with caution. Notwithstanding these limitations, we believe this is the first report comparing the effects of different opioid-based anesthetic regimens on early recovery from orthognathic surgery, and we believe this report may be used as the starting point for a controlled study.

Publisher

American Dental Society of Anesthesiology (ADSA)

Subject

Anesthesiology and Pain Medicine

Reference17 articles.

1. Intra-operative blood loss and operating time in orthognathic surgery using induced hypotensive general anaesthesia: prospective study;Yu;Hong Kong Med J,2000

2. Remifentanil for general anaesthesia: a systematic review;Komatsu;Anaesthesia,2007

3. Usefulness of remifentanil anesthesia in oral surgery—comparison of sevoflurane and propofol;Yamakage;Anesthesiology,2008

4. Postoperative nausea and vomiting (PONV) after orthognathic surgery: a retrospective study and literature review;Silva;J Oral Maxillofac Surg,2006

5. Deliberate hypotension for elective major maxillofacial surgery: a balanced halothane and morphine technique;Washburn;J Maxillofac Surg,1982

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