A case of bradycardia caused by trigeminocardiac reflex during orthognathic surgery

MIYAMOTO Jutaro, MANO Takamitsu, HORINAGA Daiju, UCHIDA Kenichiro, NAKANO Hiroyuki, UEYAMA Yoshiya

doi:10.5794/jjoms.58.439

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Other Title

顎矯正手術中に三叉－迷走神経反射により徐脈をきたしたと思われた1例
ガクキョウセイシュジュツチュウニミツマタ-メイソウシンケイハンシャニヨリジョミャクオキタシタトオモワレタ 1レイ

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Abstract

Asystole or bradycardia due to trigeminocardiac reflex is a rare complication of oral and maxillofacial surgery. We report a case of bradycardia during orthognathic surgery.<br> An 18-year-old woman with retrognathia underwent Le Fort I osteotomy, sagittal split ramus osteotomy, and genioplasty. However, preoperative electrocardiography revealed mild bradycardia. The results of blood examinations and chest radiography were within normal limits. After genioplasty had been done, bradycardia developed suddenly while suturing the mandibular mucoperiosteal flap. Surgery was immediately discontinued; cardiac massage was started, and atropine was administered intravenously. About after 20 seconds, the heart rate recovered to the normal range. No further episode of bradycardia was encountered, and the operation was finished as scheduled. We supposed that bradycardia was caused by traction of the mental nerve.<br> Oral and maxillofacial surgeons should be aware of the possibility of trigeminocardiac reflex during operation.

Journal

Japanese Journal of Oral and Maxillofacial Surgery

Japanese Journal of Oral and Maxillofacial Surgery 58 (7), 439-442, 2012

Japanese Society of Oral and Maxillofacial Surgeons

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