Hypotensive Anesthesia and Recovery of Cognitive Function in Long-term Craniofacial Surgery

• DOI: 10.1097/01.scs.0000159084.60049.e6
• Publication Date: 2005-08-03T16:11:57Z
• Authors: Valentina Caverni; Giovanni Rosa; Giovanni Pinto; Paolo Tordiglione; Roberto Favaro
• Keywords: Craniofacial surgery

The aim of our study was to compare three different anesthesiological techniques with regard hemodynamics, recovery, and postoperative morbidity, for craniofacial surgery. One hundred twenty patients American Society Anesthesiologists (ASA) classification I or II patients, 18 32 years old, undergoing maxillary mandibular osteotomies were randomly assigned receive anesthesia propofol-remifentanil (group P), desflurane-remifentanil D), sevoflurane-remifentanil S). All given premedication: midazolam 0.03 mg/kg, atropine 0.007 desametasone 0.1 NaCl 0.9% 100 mL + 2 mg/kg ketoprofene 1.5 ranitidine 1 μg/kg clonidine. Anesthesia induced by O2/air (FiO2 0.5), remifentanil 0.5 μg/kg/min, propofol rocuronium 0.6 mg/kg. Maintenance group P received 0.25 6 10 mg/kg/h; groups D S respectively, sevoflurane desflurane minimum alveolar anesthetic concentration. dosage propofol, desflurane, sevoflurane, obtained a value bispectral index (BIS) 40, kept unchanged throughout the course, titrated maintain controlled hypotension: systolic arterial blood pressure 70 90 mmHg mean 50 65 mmHg. A 24-hour elastomeric infusion system (ketoprofene 320 mg) started 60 minutes before induction cloridrat ondansetron administered 30 end Hypotension successfully in all bloodless surgical field, there no need additional use potent hypotensive agent. Early late recovery faster more complete group; < 0.05. Postoperative morbidity (nausea, vomiting, shivering, pain, edema) slight did not significantly differ among groups.