The anesthetic management and intraoperative care of patients undergoing major facial osteotomies.

Our experiences with 42 major craniofacial osteotomies--performed at The Hospital for Sick Children, Toronto, between July, 1971 and January, 1974--are related. Guidelines for operative care and anesthetic management are outlined--with regard to the length and positioning of endotracheal tubes, fluid and blood replacement, reduction of intracranial pressure, prevention of pressure necrosis, and postoperative airway care. Adherence to these principles and cooperative teamwork may prevent unexpected deaths or complications, and may minimize morbidity.