A 16-year-old girl with Bartter's syndrome was referred to our department because of malocclusion in May 2005. A clinical diagnosis of mandibular protrusion with a long face was made. After orthodontic treatment, including extraction of 4 wisdom teeth and 2 fourth molar teeth, she received orthognathic surgery by Le Fort Ⅰ osteotomy and sagittal split ramus osteotomy under general anesthesia (NLA) in December 2007. L-aspartate potassium was administered intravenously in a dose of 10 mEq/h during the operation. Postoperatively, electrolyte imbalance was corrected by administration of potassium and a prostaglandin synthesis inhibitor (indomethacin). Nausea was controlled by treatment with metaclopramide (Primperan®) and an H2-blocker (Gaster®). Inter-maxillary fixation was not performed after the operation to prevent aspiration pneumonia due to vomiting. Because of these precautions, the postoperative course was uneventful.
