Analyse blood loss in controlled hypotension for open repair fronto-orbital advancement

Abstract

Background: Transoperative blood loss is a serious challenge during correction of craniosynostosis. Open cranial remodeling is standard treatment for craniosynostosis. 1917 cushing controlled hypotension is defined as a reduction in systolic blood pressure to 80–90 mmHg, proposed benefits of reduced blood loss, better surgical visualisation, less operative time and less requirement of transfusion. Objectives: To analyse blood loss and requirement of transfusion using hypotension for open repair fronto-orbital advancement. Methods: This institutional review analysed the records in infants with craniosynostosis who required fronto-orbital advance between 2013 and 2016 in Hospital Regional Materno Infantil de Alta especialidad. Five patients were selected for this study — two patients were four years old, one was one year old, one was nine months and one seven months. Findings: Five infants underwent fronto-orbital advancement, just one patient had an associated syndrome: Apert syndrome, intraoperative transfusion was required in all patients, with controlled systemic hypotension did not affect intraoperative blood loss, and requirement of transfusion. Conclusion: Fronto-orbital advancement is safe and acceptable treatment for correction of craniosynostosis whit few intraoperative complication, however use hypotensive anaesthesia did not affect intraoperative blood loss.