Dr. Kate Tishkevich
Clinical Fellow
Topic
Orthognathic Surgery Posnick
Chapter 11: Anesthesia Techniques, Blood Loss/Fluid Replacement, Airway Management and Convalescence in the Treatment of Dentofacial Deformities.
Perioperative management is essential for achieving safe and predictable outcomes in orthognathic surgery. Deliberate hypotensive anesthesia (DHA), typically maintaining a mean arterial pressure of 50–65 mmHg, is commonly employed to reduce intraoperative blood loss. Various anesthetic and antihypertensive agents, together with hemostatic medications such as tranexamic acid and desmopressin, contribute to blood conservation. Comprehensive airway assessment, including evaluation of mouth opening, mandibular protrusion, neck mobility, Mallampati score, and thyromental distance, is critical for anesthesia planning. Postoperative care involves airway monitoring, pain control, wound management, nutrition support, and rehabilitation exercises to optimize recovery and functional outcomes.