BASIC AND CLINICAL STUDY OF PERIOPERATIVE RESPIRATORY MANEGEMENT ON ORAL AND MAXILLOFAICIAL SURGERY

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We studied the effects of intermaxillary fixation during surgery on respiratory function after general anesthesia, expecially differences caused by differences in preoperative respiratory routes.The subjects in this study were 14 healthy adults with normal respiratory function (control group) and 29 patients (patient group) subjected to sagittal osteotomy accompanied by intermaxillary fixation under general anesthesia. Measurement items were the presence of nasal breathing and oral breathing, tidal volume (VT) in each respiratory route, respiratory minute volume, respiratory rate (RR), end-tidal CO_2 concentration (EtCO_2), and oxygen saturation (SpO_2).In the control NO - N group, there were no changes in any of the measurement items before and after intermaxillary fixation except in the case of respiratory routes. In the patient NO - N group, however, the postoperatively measured tidal volume and respiratory minute volume decreased. This suggested that, after general anesthesia during orthognathic surgery involving intermaxillary fixation, oral breathing was eliminated by intermaxillary fixation, and it was suggested that the respiratory volume in the nasal breathing route compensating for this disappearance would not increase. However, the decrease in the respiratory volume was not large enough to change SpO_2. The decrease in EtCO_2 was thought to be due to the effect of dead space following the respiratory volume change. The possible causes of the decreased respiratory volume in the patient NO -N group were a change in the form of the upper airway by orthognathic surgery. This study suggested that when oral breathing is recognized before surgery, close attention should be paid to respiratory conditions after general anesthesia during intermaxillary fixation.