Effect Of Supraglottic Airway Devices On The Tempromandibular Joint Function Following Prolonged General Anesthesia

Study Overview
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Brief Summary
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Effect Of Supraglottic Airway Devices On The Tempromandibular Joint function Following Prolonged General Anesthesia

Detailed Description
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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.

Official Title
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Effect Of Supraglottic Airway Devices On The Tempromandibular Joint Function Following Prolonged General Anesthesia

Conditions
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Change of Tempromandibular Joint Function With Supra Glottic Airway Devices

Intervention / Treatment
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* Device: Supra glottic airway devices


Participation Criteria
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Eligibility Criteria
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Inclusion The study will include 60 adult patients (>18 years old) with ASA physical status class I and class II scheduled for elective surgery under general anesthesia where SADs ara planned to be used as airway devices Exclusion Criteria: Patient refusal limited mouth opening(<2 fingers) Facial &upper airway trauma Patients with dentures or who were edentulous (as accurate objective measurements would be difficult to determine) Head and neck surgery (as surgery may influence TMJ function) GITsurgery (as SAD doesn't completely protect air way against aspiration ) Pt with preexisting tempromadibular joint dysfunction Duration of anaethesia less than 1 h or more than 4hs-

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Supra glottic airway devices<br> | Device: Supra glottic airway devices<br>* Using the device in save air way in patients under general anesthesia and the change in the tempromandibular joint will be evaluated<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 | Single measurement Within 24 hours postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Other complications of supraglottic airway devices | Including aspiration and airway edema | Intra operative &24hours postoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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The interincisors distance& movements of the jaw