Anaesthesia for orthognathic surgery—a narrative review

Background and Objective: Orthognathic surgery is a commonly carried out maxillo-facial procedure which involves corrective surgery of the jaw and lower face. Over the last hundred years, the field of orthognathic surgery has gone through significant advancement in surgical and anaesthetic techniques and today, procedures can range from single jaw surgery to more complex cleft and craniofacial surgery. Currently, orthognathic surgery relies on a multi-disciplinary team working together to provide the best outcome for the patient. The anaesthetist plays a key role in the patient’s surgical journey. This article aims to review the current literature on anaesthetic practice in orthognathic surgery. Methods: An online literature search was carried out using Cochrane Library, PubMed, EMBASE, and Google Scholar from July 1990 to July 2024 on anaesthesia for orthognathic surgery. Key Content and Findings: This review outlines the current anaesthetic considerations for orthognathic surgery including details of the surgery which are relevant to the anaesthetist, peri-operative patient management and planning, airway considerations and anaesthetic techniques, i.e., shared airway management and to reduce blood loss in patients, i.e., controlled intra-operative hypotension. Advancements in surgical technique have led to improved recovery time for these patients, and some of these surgeries are now carried out as day case procedures. Conclusions: Orthognathic surgery is commonly carried out in the UK and around the world, and is generally considered a safe and effective procedure. Anaesthetists play a key role in the peri-operative management of patients.