Anaesthetic Considerations in Maxillofacial Surgery

Abstract

SUMMARY M axillofacial surgery encompasses a broad range of surgical procedures from day-case dental extractions to complex free- flap reconstructive surgery. Understanding the anatomical basis of the airway, facial skeleton and the sensory supply of the face is the primary step and essential for the anaesthesiologists involved in the care of maxillofacial surgery patients. Particular considerations for maxillofacial anaesthesia include good preoperative assessment and the choice of airway management technique at intubation including laryngeal mask airway (LMA), tracheal tube and surgical airway. Intra operative care in maintenance of anaesthesia, the use of a throat pack to prevent soiling of the lower airway, protecting the eyes from pressure and reducing nausua and vomiting. The less frequently used blocks in faciomaxillary region, but with knowledge and expertise could be used to great advantage. Anaesthesiologists should also pay attention to other parameters such as the operating time, using hypotensive anaesthesia, intra-operative blood loss and intraoperative arrhythmias. Extubation can be hazardous, top care should be given. Good analgesia and prevention of nausa and vomiting are essentials.