Pre- and Perioperative Care in Orthognathic Surgery: Anesthesiology and CMF Surgery

Modern perioperative care is complex and requires a large number of staff from different disciplines. Patient outcomes depend on well-designed processes, consistent clinical practice, and effective communication. The pre-, peri-, and postoperative care should be a unified process of multiple coordinated measures. The successful course of a surgical procedure is based on standardized pre-, peri-, and postoperative checks, notes, and orders in the operating theater, in the recovery ward, and on the normal ward. Preoperative protocol establishes what is thought to be the pathology of the patient and what procedure is planned for the operation and anesthesia. It indicates that the appropriate preoperative tests have been performed and reviewed. It also confirms the presence of an informed consent document (operation consent). Surgical care provided to a patient requires a written, signed, informed consent document. It is an essential part of the medical record. It must be properly completed prior to any invasive, anesthetic, or other procedure that involves any significant risk to the patient. Preoperative checks and orders assure that the patient is ready for surgery, and all preoperative medical instructions have been performed. All necessary laboratory exams, X-rays, consultations, implant materials, and permits must be ordered in a timely manner to ensure their availability before surgery. Similarly, preoperative determination of the intubation manner between anesthesia and CMF surgery (craniomaxillofacial) is essential in particular with regard to possible intubation problems. Perioperative notes include the anesthesia induction, anesthesia maintenance, and intraoperative ongoing monitoring and documentation of the patient’s vital functions, as well as documentation of all perioperative prophylactic measures taken to ensure a successful postoperative course.