CHOICE OF THE TECHNIQUE FOR BLOOD LOSS REDUCTION IN THE RECONSTRUCTIVE ORAL SURGERY

Goal of the study: to define the most optimal technique for blood loss reduction during reconstructive surgeries in maxillofacilal area. Materials and methods. The study included 100 patients, the patients were randomly divided into 5 groups, and after the randomization the cohort included 80 patients. Group 1 (control) (n = 12) – acute normal and hypervolemic hemodilution (ANH and AHH), infusion volume made 8-10 ml/kg x h^-1. Group 2 (n = 17) – reduction of infusion volume down to 4-6 ml/kg x h^-1 in combination with prescription of aprotinin. Group 3 (n = 17) – reduction of infusion volume down to 6-8 ml/kg x h^-1 in combination with prescription of tranexamic acid (TA). Group 4 (n = 19) – reduction of infusion volume down to 6-8 ml/kg x h-1, TA in combination with regional blocks in order to provide sympatholysis. Group 5 (n = 15) – reduction of infusion volume down to 6-8 ml/kg x h^-1, TA in combination with system sympatholysis. Colorimetry was used to evaluate blood loss. Results. All groups included into the study compared to the control group manifested reduction of blood loss and as a result reduction in the need for blood preparations transfusion. The most effective blood saving approach was the combination of the infusion volume reduction with the use of TA. The use of local and system sympatholysis did not result in the additional reduction of the blood volume. Use of ANH and AHH could result in the development of massive blood loss.

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