Remifentanil Reduces Blood Loss During Orthognathic Surgery.
Remifentanil is reported to reduce oral tissue blood flow. We performed a retrospective investigation using logistic regression analysis of anesthesia records to investigate whether the use of remifentanil infusion in a balanced anesthesia technique was useful as a primary technique to reduce blood loss during orthognathic surgery. Subjects were 80 patients who underwent Le Fort I osteotomy and sagittal split ramus osteotomy of the mandible. The variables included gender, age, weight, type of maintenance anesthetic, type and dose or infusion rate of opioid, mean systolic blood pressure (SBP-mean), coefficient of variation of systolic blood pressure (CVSBP) during surgery, mean heart rate (HR-mean), duration of surgery, total blood loss, volume of infusion used, amount of local anesthetic used, body temperature, and urine output. Gender, type of maintenance anesthetic, type of opioid, SBP-mean, CVSBP, HR-mean, and duration of surgery were used as candidates for independent variables. Logistic regression analysis was performed for the selected independent variables with the total blood loss as the dependent variable. The factors associated with the reduction of blood loss were the use of remifentanil (odds ratio, 3.112; 95% CI, 1.166-8.307; P = .023) and smaller CVSBP (odds ratio, 2.747; 95% CI, 1.07-7.053; P = .036). Use of remifentanil and smaller CVSBP were associated with a reduction of blood loss during orthognathic surgery.
['Matsuura|Nobuyuki|N|', 'Okamura|Taiki|T|', 'Ide|Satoko|S|', 'Ichinohe|Tatsuya|T|']
D000293:Adolescent D000328:Adult D000768:Anesthesia, General D018686:Anesthetics, Intravenous D016063:Blood Loss, Surgical D001794:Blood Pressure D016009:Chi-Square Distribution D005260:Female D006801:Humans D007262:Infusions, Intravenous D016015:Logistic Models D008297:Male D008334:Mandible D008875:Middle Aged D016017:Odds Ratio D056948:Orthognathic Surgical Procedures D010027:Osteotomy D010880:Piperidines D000077208:Remifentanil D012189:Retrospective Studies D012307:Risk Factors D016896:Treatment Outcome D055815:Young Adult
Remifentanil Blood loss Orthognathic surgery Logistic regression analysis General anesthesia