Abstract
In this paper, we report a patient who developed angioedema of the face and pharynx after sagittal split ramus osteotomy, leading to suffocation.
The patient was a 29-year-old female. To treat mandibular retrusion, sagittal split ramus osteotomy and maxillomandibular fixation were performed under general anesthesia. The duration of surgery was 2 hours and 30 minutes, and the volume of blood loss was 50g. Swelling of the face and pharynx was observed from 2 hours after surgery, and the SpO2 reduced, resulting in the loss of consciousness. The maxillomandibular fixation was released, and the airway was maintained using a nasal airway. After improvement of consciousness and vital signs, ICU management was performed. With respect to postoperative edema, IgE and C1 inhibitor tests were conducted, considering the possibility of allergy or hereditary angioedema. Negative reactions were observed, suggesting idiopathic or physical stimulus-related angioedema.
