ObjectiveSelection of ideal anesthetic drugs in maxillofacial surgery. Material and methodsA 22-year-old male patient weighing 75kg and 171cm in height, with no premedication. Pre-operative vital parameters were BP 120/70, HR 72×min, SpO2 96%, temperature 36.5°C, sinus rhythm on 5-lead EKG, capnograpy. Patient was subjected to 5min of pre-oxygenation through a facial mask. The sniff test was performed, good ventilation was confirmed and a Q-tip impregnated in 0.05% oxymetazoline was applied. An intravenous continuous infusion of dexmedetomidine (solution concentration of 0.8μcg/ml) was initiated at a rate of 0.05mcg/kg/h with a score of 2 on the Ramsay scale. Induction was initiated with fentanyl 3mcg/kg, propofol 2mg/kg, rocuronium 0.6mg/kg. A No. 7 Murphy endotracheal tube lubricated with a 10% lidocaine spray was introduced through the right nostril down to the nasopharynx. At the start of surgery, the dose of dexmedetomidine was increased to 0.1mcg/kg/h. Intra-operatively, BP was maintained between 84/55mmHg and 90/53mmHg, and HR between 58 and 76 per minute. ResultsThe selection of anesthetic drugs allowed for hemodynamic stability and comfort on awakening. ConclusionAnesthesia for orthognathic surgery, as it has evolved today, requires combining different anesthetic techniques in order to ensure that the patient remains calm, comfortable and reassured, with adequate post-operative analgesia.