Abstract
Purpose The purpose of the present study was to review the literature regarding the blood loss and postoperative pain in the isolated sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO). Materials and Methods Investigating the intraoperative blood loss and postoperative pain, articles were selected from 1970 to 2021 in the English published databases (PubMed, Web of Science, and Cochrane Library). Article retrieval and selection were performed by two authors, and they independently evaluated them based on the eligibility criteria. The articles meeting the search criteria had especially at least 30 patients. Results In the review of intraoperative blood loss, a total of 139 articles were retrieved and restricted to 6 articles (SSRO: 4; IVRO: 2). In the review of postoperative pain, a total of 174 articles were retrieved and restricted to 4 articles (SSRO: 3; IVRO: 1). The mean blood loss of SSRO and IVRO was ranged from 55 to 167 mL and 82 to 104 mL, respectively. The mean visual analog scale (VAS) scores of the first postoperative day were 2 to 5.3 in SSRO and 2.93 to 3.13 in IVRO. The mean VAS scores of the second postoperative day were 1 to 3 in SSRO and 1.1 to 1.8 in IVRO. Conclusion Compared to traditional SSRO, IVRO had a significantly lower amount of blood loss. However, the blood transfusion is not necessary in a single-jaw operation (SSRO or IVRO). Postoperative pain was similar between SSRO and IVRO.
Highlights
Orthognathic surgery has a varying level of complexity and high technical requirements
139 articles were retained by further narrowing to 6 articles [15,16,17,18,19,20] (SSRO: 4; intraoral vertical ramus osteotomy (IVRO): 2) whose domain is in a singlemandibular operation (Table 1)
IVRO had a total of 23 articles using the search terms “intraoral vertical ramus osteotomy” and “pain” in the PubMed (n = 13), Web of Science (n = 8), and Cochrane Library (n = 2) databases
Summary
Orthognathic surgery has a varying level of complexity and high technical requirements. Surgeons should pay attention to other main issues, such as preoperative assessment of the patient’s medical condition, duration of operation, intraoperative blood loss, degree of postoperative pain, potential postoperative sequelae, and complications. Surgeons take into consideration the anxiety of patients. Patients worry about the potential need for blood transfusion due to intraoperative blood loss and may question the safety of various risk factors related to blood transfusion. Estimations of operation time and blood loss must be precise which is beneficial to the promotion of communication between the surgeons, anesthesiologists, patients, and their families to have sufficient understanding of the overall operation process. Postoperative pain management is a major concern for surgical patients. Poor postoperative pain control negatively affects patient’s emotions, which in turn affect postoperative quality of life and appropriate expectations of the prognosis
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