Deliberate hypotension for elective major maxillofacial surgery: a balance halothane and morphine technique

The deliberate hypotensive technique presented here reduces blood loss and operating time during elective major maxillofacial surgery. All the patients in this study had an uneventful course following surgery and were dismissed in satisfactory condition. The one death, while possibly related to halothane, was not related to the hypotensive technique employed. Only one patient required blood replacement and this was due to preoperative anaemia. The hypotensive properties of halothane and morphine are synergistic and sufficient to reduce and control arterial blood pressure during surgery. Further, the use of controlled intermittent ventilation, fluid management, and body position complement the induced hypotension. This yields a technique which is capable of producing significant reduction in arterial blood pressure without the use of potent vasodilators and ganglionic blocking agents with associated undesirable effects.