Abstract
Postoperative nausea and vomiting (PONV) is a typical complication of orthognathic surgery. D2 receptor antagonist is commonly used as an anti-emetic drug, but it also has a potential risk of inducing extrapyramidal reaction. We report a case of acute dystonia probably caused by intravenous infusion of D2 receptor antagonist in a patient with jaw deformity during the perioperative period. The patient was a 21-year-old man who was diagnosed as having maxillary protrusion. He underwent intraoral vertical ramus osteotomy under general anesthesia which was uneventfully performed using sevoflurane and remifentanyl. Immediately following the surgery, droperidol was administered in order to prevent PONV. After emergence, he complained of nausea and D2 receptor antagonist was administered, but had no effect. On the first postoperative day, he showed acute dystonia with nystagmus and opisthotonus. Diazepam was administered and his symptom disappeared. We should pay attention to acute dystonia when using D2 receptor antagonist and need to develop effective management methods for preventing PONV.
