an evaluation of cardiac bio -markers levels after plastic face surgeries under hypotensive anesthesia

Cosmetic surgery procedures because of prolonged use of induced hypotension, bleeding, and the relative hypovolemia, have special considerations. Some believe that prolonged intraoperative hypotension can cause myocardial ischemia and increase in troponin level in the absence of myocardial infarction and can occur only with small size cardionecrosis. Present study was designed to investigate the possibility of intraoperative myocardial ischemia with CPK-MB and troponin measurement after cosmetic surgery procedures to determine whether induced hypotension can cause an increased risk of intraoperative myocardial injury?

40 candidates for facial plastic surgery and rhinoplasty, ASA I- II patients, aged 17-45 years were included. Anesthesia protocol was similar in all patients. 6 hours after the end of surgery, in all patients troponin I and CPK-MB were measured and the results were compared.

CPK-MB and troponin I were in the normal range in all patients. Mean CPK-MB was 22.5±8.3 and mean troponin I was 0.29±0.26, Mean amount of bleeding= 213.75cc (maximum= 450cc and minimum= 100cc).

Face plastic surgery and the use of induced hypotension have no additional risk for myocardial ischemia, thus prevention of perioperative adverse events in these patients can prevent perioperative death and complications.