Cardiac dysrhythmias complicating maxillofacial surgery.

Cardiac asystole, bradycardia and other dysrhythmias are complications associated with surgery of the craniofacial and maxillofacial structures. These dysrhythmias have been discussed frequently in ophthalmology but less attention has been paid to this problem in the maxillofacial surgery literature. Eight patients, 6 men and 2 women, who underwent maxillofacial surgery during a 16-month period at the Victoria General Hospital, Halifax, Canada demonstrated either asystole or bradycardia. This group of patients represents 1.6% of the total number of patients treated during the 16-month period. Six patients demonstrated either asystole or bradycardia during stretching of the soft tissues associated with advancement of the maxilla after bony mobilization. Two patients had either asystole or bradycardia during manipulation of the temporalis muscle fibres during surgery to correct total bony ankylosis of the temporomandibular joint. The etiology of this relatively rare but troublesome complication is discussed.