Comparison of different hypotensive anaesthesia techniques in orthognathic surgery with regard to intraoperative blood loss, quality of the surgical field, and postoperative nausea and vomiting

Sixty-three consecutive patients undergoing bimaxillary surgery between June and August 2015 were included in this study. Twenty-one patients were included in each of three study groups. In group 1, sevoflurane was the sole maintenance anaesthesia agent used; in group 2, propofol was the predominant agent, in addition to a reduced amount of sevoflurane; in group 3, patients received sevoflurane until fixation was completed, at which point it was switched to propofol. The mean intraoperative blood loss (ml) was 707.14 ± 290.74 in group 1, 917.62 ± 380.30 in group 2, and 750.00 ± 331.84 in group 3; the difference between groups 1 and 2 was significant (P = 0.047). The mean score for the quality of surgical field assessment was 1.32 ± 0.44 in group 1, 2.04 ± 0.49 in group 2, and 1.45 ± 0.53 in group 3 (P = 0.003). The postoperative nausea and vomiting (PONV) rate was 28.6% in group 1, 9.5% in group 2, and 14.3% in group 3 (P = 0.343). The quality of the surgical field was significantly better in groups 1 and 3 than in group 2. The average blood loss in group 1 was also significantly less than in group 2. The PONV rates were lower than those reported in other studies.