How common is tachycardia during rhinoplasty and can it be managed?

Question

I'm doing research on potential complications that could arise during rhinoplasty to figure out what to ask during my 2 upcoming rhinoplasty consultations w/ board-certified, experienced plastic surgeons. I read one story about someone in Peru who died from tachycardia after rhinoplasty. Even if it's rare, hearing stories like this really scares me. I did have general anesthesia tough almost 9 years ago for a tooth extraction and that went smoothly without any complications.

Tim Neavin, MD · Answer

Thank you for your question. Every surgery comes with risks. It is not uncommon to have tachycardia in patients undergoing any kind of surgery. I would advise you to
schedule a consultation with a board certified plastic surgeon for a detailed
examination to discuss all possible treatment options and what your
expectations are.

Eric M. Joseph, MD · Answer

Tachycardia is common during the injection of local anesthetic in the nose before we perform rhinoplasty. This has not been a source of complication and typically goes away several minutes after the anesthetic is injected. Thank you. Dr Joseph

Mark K. Markarian, MD, MSPH, FACS · Answer

Death from tachycardia after elective surgery is extremely rare, whether it's a rhinoplasty or any other surgery.  Please understand that it is possible to find documentation on practically any complication if you research hard enough on-line.  There are always "ghost stories", domestic or overseas.  As I have expressed in previous answers to your concerns about anesthesia during a rhinoplasty,  I would confine my anesthesia concerns to your preoperative consultation with a board certified anesthesiologist.  Rhinoplasty is typically a safe procedure when done under general anesthesia in patients who have undergone preoperative clearance and the proper risk stratification, and when the surgery is performed in a hospital or certified surgery center.  I think a global on-line search for rhinoplasty complications is not an efficient use of your time, and may lead to unnecessary concern on your part.  Good luck.
  
Mark K Markarian, MD, MSPH, FACS
  
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Scott Trimas, MD · Answer

Tachycardia can arise from injections of epinephrine, topical vasoconstrictors, and topical cocaine which is often used in a rhinoplasty procedure. Unfortunately, anesthesia and surgery is often not regulated in other countries so it would be like comparing apples and oranges. Most surgeries performed in the USA under general anesthesia are at accredited and licensed centers so they should have drugs to treat tachycardia should this arise. It is more common in younger women but is normally easy to control by the anesthesia provider.

Tanveer Janjua, MD · Answer

If done properly by an experienced anesthesiologist, general anesthesia is very safe. It is unlikely to get any delayed tachycardia. Any immediate tachycardia during surgery can be managed by the anesthesiologist.  Do your home work on the anesthesiologist as well, not just the surgeon. RegardsDr. J

Ronald J. Edelson, MD · Answer

Rhinoplasty is quite safe with modern anesthesia. Sometimes you will hear of a case like that in Peru that scares you, but it doesn’t really tell you the whole story. Was an anesthesiologist involved? Did the death occur during surgery or after? Most of the time the culprit is an airway issue which will cause tachycardia. So the tachycardia may not have been the primary cause. Many unanswered questions but if you have an anesthesiologist in attendance the risk is very low.

J. Phillip Garcia, MD, FACS · Answer

Exceedingly rare. Tachycardia during surgery is an effect (not a cause) of something else like an undiagnosed medical problem or use of epinephrine during surgery. It can happen during surgery and is controlled by the anesthesia provider if necessary.  Make sure your surgeon has the system in place to handle any medical issues should they arise during surgery.

Thomas J. Walker, MD, FACS · Answer

Modern anesthesia nowadays is very safe. When you hear stories like this one, there is usually much more to it than what is being reported. Complications associated with rhinoplasty and the accompanying anesthesia are very rare. There are guidelines regarding pre-operative testing and in an otherwise healthy individual, surgery- and anesthesia-related complications are exceedingly rare. Please note that you also mentioned in your question that the surgery took place in another country with guidelines regarding peri-operative testing and treatment likely being different from those in the United States.

Steven J. Pearlman, MD, FACS · Answer

Rhinoplasty and the accompanying anesthesia is very safe. Complications are very rare. When one reads about something like this, often there are other circumstances that existed that are not being reported. Anestheia is actually one of the few specialities that has had malpractice rates go down over the past few decades since there are so many new monitors and ways to check and control medical issues that might arise.

Nilay Shah, MD · Answer

Thank you for your question.You are on the right path of educating yourself at the right platform before opting for any surgery. Usually, when you go to plastic surgeon they will examine you to understand complexity of surgery and decide anesthesia accordingly. It is not uncommon to have tachycardia in young patients undergoing any kind of surgery. If surgery is done in certified operating room under the care of certified anesthesiologist, tachycardia can be treated appropriately without any major consequences. Besides worrying about anesthesia, it is very important to ask your plastic surgeon right questions including your expectation and goals with surgery.

How common is tachycardia during rhinoplasty and can it be managed?

Answers (14)

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