Unexpected Difficult Intubation in a Patient with Normal Airway on Assessment

Lim, Byoung-Sung; Andrews, R W

doi:10.1177/0310057x0102900617

Cited by 9 publications

(3 citation statements)

References 13 publications

(15 reference statements)

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“…[ 6 10 ] However, sometimes it may occur even in normal TMJ. [ 5 9 ] No history of TMJ disease was forthcoming in the present case. History of TMJ disease is often missed on routine preoperative history and patient may not be forthcoming with the problem unless specifically asked for.…”

Section: Discussionmentioning

confidence: 91%

“…[ 2 ] It has been suggested as a cause of a “locked-jaw” in earlier publications. [ 3 4 5 6 ] It is likely that this would occur during the course of airway management[ 2 7 ] Even simple maneuvers like chin lift and jaw thrust could precipitate this complication. [ 8 9 ] Holding the face mask with jaw thrust in the presence of muscle relaxation could have triggered the event in this case.…”

Section: Discussionmentioning

confidence: 99%

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Unanticipated cannot intubate situation due to difficult mouth opening

Akasapu

Wuduru

Padhy

et al. 2015

J Anaesthesiol Clin Pharmacol

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We report a case of unanticipated difficult endotracheal intubation secondary to an abrupt onset of difficulty in opening the mouth in an anesthetized adult. A female aged 76 years with American Society of Anesthetists risk Class IV E with an apparently normal preoperative temporomandibular joint was scheduled for emergency laparotomy. Following rapid sequence induction, and muscle relaxation with rocuronium, the anesthesiologist noticed lock-jaw when intubation was attempted. She was ventilated with nasopharyngeal airway, but was progressively desaturating. An emergency tracheostomy was performed. Unfortunately, she sustained cardiac arrest and could not be revived. The complication of the lock-jaw is a nightmare to airway management, especially in an unprepared situation.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Unanticipated cannot intubate situation due to difficult mouth opening

Akasapu

Wuduru

Padhy

et al. 2015

J Anaesthesiol Clin Pharmacol

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show abstract

“…Temporomandibular disorders must also be identified as they can be exacerbated if the mouth remains open for prolonged durations, even in the absence of temporomandibular disorders. There has been a case in which temporomandibular joint locking occurred during surgery which eventually led to temporomandibular disorders [ 22 23 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of dental status using a questionnaire before administration of general anesthesia for the prevention of dental injuries

Lee

Kim

Park

et al. 2023

J Dent Anesth Pain Med

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Background Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists’ responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen’s kappa coefficient κ ≥ 0.6). Conclusions A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a “yes” response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

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Airway Management in the Intensive Care Unit

Jablonka¹,

Rosenblatt²

2010

Surgical Intensive Care Medicine

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Unexpected Difficult Intubation in a Patient with Normal Airway on Assessment

Cited by 9 publications

References 13 publications

Unanticipated cannot intubate situation due to difficult mouth opening

Unanticipated cannot intubate situation due to difficult mouth opening

Evaluation of dental status using a questionnaire before administration of general anesthesia for the prevention of dental injuries

Airway Management in the Intensive Care Unit

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