Induced hypotension for orthognathic surgery

Achieving satisfactory hemostasis during orthognathic surgery may be difficult because of the extensive vascularity of facial structures. Hypotensive anesthetic techniques provide clear operative fields by altering regional tissue perfusion through the use of systemic vasodilators, ganglionic blocking agents, and positioning of the patient. Thorough monitoring during surgery, careful selection of patients, and close communication between the surgeon and anesthesiologist permit safe anesthesia, can decrease operating time, and usually obviate the need for transfusions.