Akademik Veri Yönetim Sistemi
AÇBİD 2024, Antalya, Türkiye, 10 - 14 Mayıs 2024, ss.60
Severe Bradycardia Cases Encountered During Temporomandibular Joint Arthrocentesis: Presentation of Two Cases
Objective: Arthrocentesis of the temporomandibular joint (TMJ) is a low-cost,
minimally invasive procedure frequently used for management of certain TMJ disorders.
As well as common complications such as infection, perforation of the external auditory
canal,extravasation of fluid into soft tissues and TMJ cartilage damage, bradycardia may also
develop as a very rare complication during this procedure. This paper discusses two cases of
severe bradycardia encountered during TMJ arthrocentesis.
Cases: Two patients underwent arthrocenthesis procedure under general anesthesia. In the
first case, who was a 35-year-old male, the pulse dropped from 62 to 35 beats per minute during
the lavage. After administering 1 mg of intravenous atropine, the pulse returned to normal.
In the second case, a 47-year-old female patient with controlled hypertension experienced a
drop in pulse from 75 to 32 beats per minute during the lavage. Upon no response to 1 mg of
intravenous atropine, 0.00001 mg of intravenous adrenaline was administered and the pulse
returned to normal. The procedures were completed without any further complications in both
patients.
Conclusion: Bradycardia is a serious complication that can lead to asystole or even death. The
possible mechanism of this complication may be explained by the pressure and pain occured
during the lavage which may lead to stimulation of vascular and neural structures in TMJ
region. It is of utmost importance to closely monitor the patient’s heart rate and other vital
signs during the arthrocentesis for a potential bradycardia.