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[INFUSION THERAPY IN RECONSTRUCTIVE MAXILLOFACIAL SURGERY].

Zajcev A Yu, K V Dubrovin, V A Svetlov

    Anesteziologiia I Reanimatologiia
    |July 30, 2016
    PubMed
    Summary
    This summary is machine-generated.

    The optimal intraoperative infusion rate for maxillofacial surgery is 6-8 ml/kg/h. Lower rates risk hypovolemia, while higher rates may increase blood loss due to dilutional coagulopathy.

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    Area of Science:

    • Anesthesiology
    • Surgical Oncology
    • Critical Care Medicine

    Background:

    • Restricted infusion strategies combined with antifibrinolytics (aprotinin, tranexamic acid) aid blood conservation in maxillofacial surgery.
    • However, reduced infusion volumes may precipitate intraoperative hypovolemia.

    Purpose of the Study:

    • To evaluate the compensatory effects of various infusion therapy regimens and antifibrinolytics on intraoperative volume status and electrolyte balance during reconstructive maxillofacial surgery.

    Main Methods:

    • A study involving 65 patients divided into four groups.
    • Groups received different infusion rates (4-12 ml/kg/h) and antifibrinolytic agents (aprotinin, tranexamic acid), with one group also receiving regional analgesia.
    • Central hemodynamics, peripheral perfusion, water-electrolyte balance, and acid-base status were assessed.

    Main Results:

    • All infusion strategies successfully maintained positive volume balance despite blood loss and diuresis.
    • No instances of hypovolemia or peripheral perfusion insufficiency were reported.
    • Water-electrolyte and acid-base balances were maintained; however, the 4-6 ml/kg/h infusion group showed CVP and diuresis near critical levels, posing risks in uncontrolled bleeding.

    Conclusions:

    • An optimal intraoperative infusion rate of 6-8 ml/kg/h is recommended for reconstructive maxillofacial surgery.
    • Infusion rates of 8-12 ml/kg/h may increase blood loss via dilutional coagulopathy.
    • Rates of 4-6 ml/kg/h carry a relative risk of hypovolemia and are not advised.