Evaluation of the Anesthetic Management of Patients Operated for Maxillofacial Reconstruction Surgery in a Sub-Saherian Country: About Six Observed Cases

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Introduction: The main challenge of general anesthesia in maxillofacial surgery is the maintenance of airway patency in a specialty where the anatomy of the upper airway can be modified. The aim of our work is to evaluate the anesthetic management of patients operated for maxillofacial reconstruction surgery. Patients and methods: This is a prospective descriptive observational study of six (06) patients operated for maxillofacial reconstruction surgery as part of a mission with a Western team. For each patient, we collected preoperative, intraoperative and postoperative data. Data analysis and processing were performed with Sphinx Plus software (Version: V5.TuiTe). Results: In this report of 06 patients, with a clear female predominance (sex ratio = 0.2) with an average age of 26 years, 66.6% benefited from a mandibulectomy + fibula flap against 33.3% for frontal tumor excision + parietal flap. Preoperatively, no limitation of mouth opening, the Mallampati score was > 2 in 2 patients or (1/3 patients), only one case of anemia at 9.7 g/dl (16.6%) for an average hemoglobin level of 12.4. Intraoperatively, all patients benefited from intravenous induction: rapid sequence in one patient (16.6%), classic sequence in 05 patients (83.3%). The average duration of surgery was 384 min with extremes of 210 min and 615 min. Estimated blood loss was on average 441 ml [50-1000 ml], with a transfusion rate of 50% and a noradrenaline use rate of 16.6% without hemorrhagic shock objectified in our series. Postoperative complications were represented by one or two cases of flap ischemia (33.3%) requiring surgical revision and one case of submaxillary hematoma, i.e. 16.6%. Conclusion: Maxillofacial reconstruction surgery is associated with a success rate that can be improved in our regions. And this requires a unwavering commitment to improving the technical platform as well as continuous training of staff.