抄録
Bimaxillary osteotomy is an invasive procedure with a serious risk of bleeding and airway complications. Lidocaine with adrenaline is preferentially used to prolong local analgesia and reduce bleeding. The local anesthetic dose for this procedure can be quite high. Sustained tachycardia, potentially caused by either the adrenaline or other factors, is sometimes observed perioperatively. The anesthesia records of patients undergoing bimaxillary osteotomy between January 2021 and December 2021 were reviewed. The records of non-osteotomy patients treated between March 2019 and March 2024 with a surgical time longer than four hours were used as a control group. Possible contributing factors, such as age, sex, and dose of administered local anesthetics, were used as objective variables in a binary logistic regression analysis. The dose of lidocaine was found to be a significant negative contributing factor for tachycardia at the end of anesthesia （odds ratio ［OR］, 0.958; 95％ confidence interval ［CI］, 0.921-0.997; p＝0.035）. Other significant factors were sex （OR, 9.674） and body weight （OR, 0.908）. The local anesthetic was thought to have contributed to pain control, rather than inducing tachycardia, due to the supplemental adrenaline, and men were more prone to developing tachycardia than women. Although we failed to clarify the etiological mechanism for tachycardia after bimaxillary osteotomy, supplemental adrenaline may not be a significant cause of tachycardia during emergence from anesthesia.
