Factors Affecting Intraoperative Blood Loss in Orthognathic Surgery : A Monocentric Retrospective Study

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  • Sayaka ASANO
    Department of Anesthesiology, Tokyo Metropolitan Tama Medical Center Department of Dental Anesthesiology and Orofacial Pain Management, Tokyo Medical and Dental University
  • Hirotoshi YAMAMOTO
    Department of Anesthesiology, Tokyo Metropolitan Tama Medical Center
  • Shigeru MAEDA
    Department of Dental Anesthesiology and Orofacial Pain Management, Tokyo Medical and Dental University

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<p>  Introduction : Orthognathic surgery (OGS) is widely performed in Japan. Although the number of upper and lower jaw surgeries is increasing, the average amount of blood loss is decreasing.</p><p>  Materials and Methods : Using multivariate analysis, the present, retrospective, observational study examined factors affecting intraoperative bleeding in OGS performed in the past 13 years in the Department of Oral Surgery of Tokyo Metropolitan Tama Medical Center.</p><p>  Results : In total, 157 patients were included : the mean blood loss was 205.7 ml, and the mean operative time was 236.4 minutes. Female patients comprised 104 cases of surgery in total, which included 78, 30, and 27 cases of maxillary surgery, total intravenous anesthesia, and tranexamic acid therapy, respectively. Multiple regression analysis revealed that operative time had the strongest effect on blood loss. Male sex was also associated with blood loss of approximately 60 ml. In contrast, tranexamic acid therapy reduced blood loss by approximately 70 ml. The difference in the type of surgery was a confounding factor of operative time rather than an independent factor.</p><p>  Conclusion : Even a sagittal split ramus osteotomy alone carries the risk of increased blood loss if the operative time is prolonged. Among multifaceted approaches of reducing blood loss, prophylactic tranexamic acid administration may be effective if prolonged operative time is anticipated.</p>

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