Impact of strict controlled hypotension on intraoperative hemorrhage and postoperative renal function in orthognathic surgery

doi:10.19438/j.cjoms.2026.02.009

Abstract

Abstract: PURPOSE: To evaluate the effect of strict controlled hypotension (mean arterial pressure≤55 mmHg) on intraoperative blood loss and postoperative renal function in orthognathic surgery. METHODS: A total of 117 patients who underwent orthognathic surgery in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from May 2024 to March 2025 were selected and divided into the strict controlled hypotension group (group S, MAP≤55 mmHg) and the conventional management group (group C, MAP>55 mmHg) according to the intraoperative blood pressure management strategy. The primary indicators such as intraoperative blood loss and postoperative incidence of acute kidney injury, as well as the secondary indicators such as postoperative hemoglobin, hematocrit and operation duration, were compared between the two groups. RESULTS: The intraoperative blood loss in group S was significantly lower than that in group C (P<0.001). There were no significant differences in postoperative creatinine, Δ creatinine (the difference between postoperative and preoperative creatinine) and creatinine variation rate between the two groups (P>0.05). The postoperative hemoglobin and hematocrit in group S were significantly higher than those in group C (P<0.05), and the hypotension duration in group S was significantly longer than that in group C (P<0.001). There were no significant differences in intraoperative urine output, operation time, allogeneic blood transfusion rate, postoperative adverse event rate and length of hospital stay between the two groups (P>0.05). CONCLUSIONS: The implementation of strict controlled hypotension (MAP≤55 mmHg) in orthognathic surgery can effectively reduce intraoperative blood loss without increasing the risk of postoperative renal function injury and adverse events, and has good safety.

Key words: Orthognathic surgery, Controlled hypotension, Postoperative blood loss, Acute kidney injury, Postoperative complications

CLC Number:

R780.05

Xu Yunxin, Liu Hua, Lyu Xiang. Impact of strict controlled hypotension on intraoperative hemorrhage and postoperative renal function in orthognathic surgery[J]. China Journal of Oral and Maxillofacial Surgery, 2026, 24(2): 150-154.

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