DOI: 10.69601/meandrosmdj.1915788 ISSN: 2149-9063

Intraoperative Effects of Controlled Hypotensive Anesthesia in Bimaxillary Orthognathic Surgery: A Retrospective Comparative Cohort Study

Burcu Gürsoytrak, Zeynep Büşra Gür, Özlem Kocatürk, Ömer Uranbey
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Objective:To evaluate the intraoperative effects of controlled hypotensive anesthesia in patients undergoing bimaxillary orthognathic surgery and to compare surgical field quality and operative time between hypotensive and normotensive anesthetic management protocols.Materials and Methods:This retrospective comparative cohort study included consecutive adult patients who underwent bimaxillary orthognathic surgery (Le Fort I osteotomy and bilateral sagittal split osteotomy) at a single tertiary center between January 2015 and October 2020. Patients with ASA physical status I–II and complete anesthetic and surgical records were included. According to anesthesia records, patients were allocated to a normotensive group or a controlled hypotensive anesthesia group. All operations were performed by the same department using standardized surgical protocols. The primary outcomes were operative time and intraoperative surgical field quality assessed using the Fromme ordinal scale. Intergroup comparisons were performed using the Mann–Whitney U test and chi-square test, with p < 0.05 considered statistically significant.Results:A total of 28 patients were included: 15 in the normotensive group and 13 in the hypotensive group. Baseline demographic characteristics, including age, sex, body weight, and ASA distribution, were comparable between groups (all p > 0.05). Mean operative time was significantly shorter in the hypotensive group than in the normotensive group (342.3 ± 55.8 vs 383.0 ± 54.3 minutes; p = 0.03). Surgical field quality was also significantly better in the hypotensive group, with a lower mean Fromme score (1.23 ± 0.92 vs 3.06 ± 1.03; p ≤ 0.001).Conclusion:Controlled hypotensive anesthesia was associated with improved intraoperative surgical field quality and shorter operative time in bimaxillary orthognathic surgery. These findings suggest that it may enhance surgical working conditions in routine clinical practice, although larger prospective studies are needed for confirmation.

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