الفهرس 
Maxillofacial surgeryOnly 14 pages are availabe for public view
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Abstract
This prospective controlled randomized study was designed to speculate the effect of hypotensive general anaesthesia using either magnesium sulphate or nitroglycerine on haemostatic markers, blood loss, surgical field and operative time in maxillofacial surgery. Forty five patients of either sex, aging 20-50 years, ASA I or II, subjected to maxillofacial surgery were included in this study. They were randomly allocated into three equal groups (15 patients each); group I: normotensive group (NG), group II : magnesium hypotensive group (MHG) (50 mg/kg loading dose started immediately after induction of anaesthesia followed by continuous infusion 1-5 g/h), group III: nitroglycerine hypotensive group (NHG) (0.5-5 g/kg/min started immediately after induction of anaesthesia). Recorded clinical data included HR, MAP, SpO2, PETCO2, blood loss, ACS for surgical field, 4 point rating scale for sedation, and operative time. Laboratory data included CBC, APTT, TT, fibrinogen level, PT and PA. This study displayed a significant decrease of blood loss and improved quality of the surgical field in both MHG and NHG compared to NG but operative time was comparable among the three groups. The sedation score was significantly higher in MHG in comparison with NG and NHG. Haemoglobin concentration and all coagulation parameters were significantly decreased postoperatively when compared with the preoperative values without significant intergroup differences apart from significant increase of PA in the two hypotensive groups in comparison with the NG. From this study we concluded that hypotensive anaesthesia irrespective of the agent used resulted in reduced blood loss and improved quality of the surgical field during maxillofacial surgery as compared to normotensive anaesthesia with no effect on operative time. In addition, there was a significant increase of PA with hypotensive anaesthesia.