Effect Of Supraglottic Airway Devices On The Tempromandibular Joint function Following Prolonged General Anesthesia
Supraglottic airway devices (SADs) are used for securing the airway in over 50% of general anesthetics; They are used for both spontaneously \& ventilated patients; They also used as conduits to aid endotracheal intubation when both positive mechanical ventilation ( PMV) \& tradional endotracheal intubation( ETT) have failed All (SADs) consist of a tube that connected to a breathing circuit or a breathing bag which is attached to a hypopharengeal device that seals air flow to the glottis There are many types of SADs including I-Gel, intubating laryngeal mask airway (LMA), LMA CTrash and LMA proseal Although considered relatively safe devices; and have many advantages as they are less invasive than EET, less incidence of bronchospasm, don't often require muscle relaxation or neck mobility There are several potential complications \& disadvantages ; Include temporomandibular joint (TMJ) dysfunction, increases the risk of aspiration, more gas leak \&pollution, less safe in prone postion \& deeper anaethesia is required This study will investigate (TMJ) dysfunction following the use of a (SAD) during general anesthesia, as There are a number of insertion maneuvers described for (SADs) \[2\] such as a jaw thrust may result in temporomandibular joint (TMJ) dysfunction by anteriorly displacing the mandible . In addition, other factors such as degree of muscle relaxation leading to hypotonicity of jaw muscles and passive mouth opening. In addition, for the duration of the operation the mouth is kept slightly open by a breathing tube may result in (TMJ) dislocation. The inter-incisor distance will be measured using a Therabite â ruler (ATOS Medical, Nottingham, UK). This has a scale from 0 to 70 mm with 1-mm markings. The accuracy of this type of ruler is1.0 mm. The Therabite ruler was chosen as it routinely used by the investigators for (TMJ) assessment in the maxillofacial clinic.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SCREENING
Masking
NONE
Enrollment
60
Using the device in save air way in patients under general anesthesia and the change in the tempromandibular joint will be evaluated
Change in tempromandibular jiont function
The change in inter incisors distance,forword movement\&lat movement of the jow post operative will be measured also any post op pain or difficulty in movement of the jow will be recorded
Time frame: Single measurement Within 24 hours postoperative
Other complications of supraglottic airway devices
Including aspiration and airway edema
Time frame: Intra operative &24hours postoperative
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