The Effect of Antihypertensive Agents Concerning With Hemodynamics and Reduction of Anaesthetics in Orthognathic Surgery

Study Overview
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Brief Summary
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For those who receive hypotensive anesthesia in orthognathic surgeries, the investigators premedicate with anti-hypertensive agent so that it decreases the occurence of tachycardia and the rebound hypertension due to hypotensive anesthesia, enabling us to compare hemodynamic stability and reduction of anesthetic agents during the operation.

Conditions
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Orthognathic Surgery

Intervention / Treatment
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* Drug: b-blocker(Atenolol)
* Drug: ACE inhibitor(Enapril)
* Other: control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA class I-II obtaining written informed consent from the parents aged 18-29 years who were undergoing orthognathic surgery. Exclusion Criteria: Hypertension patients with anti-hypertensive agents chronic renal failure or End stage renal disease patients. renal artery stenosis history. Patients who are with medication due to systemic disease. symptomatic asthma Drug hyperactivity neurological or psychiatric illnesses mental retardation patients who can't read the consent form due to illiterate or foreigner

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 29 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Atenolol<br>In each group, premedication with either b-blocker (Atenolol) or ACE inhibitor (enalapril) or nothing (control group) in the preparation room. | Drug: b-blocker(Atenolol)<br> <br> |
| Active Comparator: Enalapril<br>In each group, premedication with either b-blocker (Atenolol) or ACE inhibitor (enalapril) or nothing (control group) in the preparation room. | Drug: ACE inhibitor(Enapril)<br> <br> |
| Placebo Comparator: control<br>none of antihypertensive agents | Other: control<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the influence of antihypertensive agents on hemodynamic stability | Total minutes when the MAP is lower than 55mmHg and higher than 65mmHg (min) , The time below 55 mmHg(min) , The total time above 65 mmHg (min) Total remifentanil amount, total NTG amount, total phenylephrine amount Arterial gas analysis 4 times after induction, at the start of manipulation of mandible, at the start of manipulation of maxilla, at the end of surgery. Pr-operative and post-operative lab (Hb, Bun, Cr, OT, PT, Na, K) Intraoperative total fluid, total urine amount, total blood loss, transfusion amount. | From the beginning until the end of hypoetensive anesthesiaan expected average of 65 mins.(From manipulration of Mandible to maxilla) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| reduction of anaesthetics with control | Total minutes when the MAP is lower than 55mmHg and higher than 65mmHg (min) , The time below 55 mmHg(min) , The total time above 65 mmHg (min) Total remifentanil amount, total NTG amount, total phenylephrine amount Arterial gas analysis 4 times after induction, at the start of manipulation of mandible, at the start of manipulation of maxilla, at the end of surgery. Pr-operative and post-operative lab (Hb, Bun, Cr, OT, PT, Na, K) Intraoperative total fluid, total urine amount, total blood loss, transfusion amount. | From the beginning until the end of hypoetensive anesthesia an expected average of 65 mins.(From manipulration of Mandible to maxilla) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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antihypertensive agents, hemodynamic, anesthetics reduction, orthognathic surgery