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[不同全身麻醉程序中颞下颌关节功能的变化]

[Changes in temporomandibular joint functions in various general anesthesia procedures].

作者信息

Lipp M, Daubländer M, Ellmauer S T, von Domarus H, Stauber A, Dick W

机构信息

Klinik für Anaesthesiologie, Johannes Gutenberg-Universität Mainz.

出版信息

Anaesthesist. 1988 Jun;37(6):366-73.

PMID:3407900
Abstract

In a clinical study conducted in 1986 on 100 patients, we were able to demonstrate that intubation leads to the occurrence of temporary disturbances of the stomatognathic system. To verify these results, a double-blind study was conducted involving 140 patients of ASA groups I and II. Further acceptance criteria were: operation outside of the head and neck area, no throat pack or gastric tube, and the requirement of dental antagonists on the left and right side. Group composition: Group A: oral intubation with a laryngoscope (n = 50); Group B: nasal intubation using a fiberoptic endoscope (n = 40); Group C: face mask (n = 50) Groups A and B were divided at random. Balanced anesthesia was performed for all patients. In group B, after nasal intubation the mandible was placed and fixed in the habitual occlusion position. The patients had a dental examination preoperatively and on 1st, 2nd and 3rd postoperative day. Parallel to this study, we also interviewed 400 patients after routine intubation anesthesia with regard to postoperative temporomandibular joint (TMJ) symptoms. Groups A, B, and C were comparable in age, sex, height, weight, preoperative values of maximal mandibular movement, and pathological findings of the TMJ (Tables 1-3); the only differences were a longer mean duration of surgery in groups A and B than in group C (P greater than 0.05) and that women described more stomatognathic disorders in the preoperative medical history than men.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在1986年针对100名患者开展的一项临床研究中,我们得以证明插管会导致口颌系统出现暂时性紊乱。为验证这些结果,对140名ASA I级和II级患者进行了一项双盲研究。进一步的纳入标准为:头颈部区域以外的手术、无喉罩或胃管,以及左右两侧均有牙合支托。分组情况:A组:使用喉镜经口插管(n = 50);B组:使用纤维光学内窥镜经鼻插管(n = 40);C组:面罩(n = 50)。A组和B组随机分组。所有患者均实施平衡麻醉。在B组中,经鼻插管后将下颌放置并固定于习惯性咬合位置。患者在术前以及术后第1、2和3天接受牙科检查。与该研究并行,我们还就术后颞下颌关节(TMJ)症状对400例行常规插管麻醉后的患者进行了访谈。A、B和C组在年龄、性别、身高、体重、术前最大下颌运动值以及TMJ的病理检查结果方面具有可比性(表1 - 3);唯一的差异是A组和B组的平均手术持续时间比C组长(P>0.05),且女性在术前病史中描述的口颌系统紊乱情况比男性更多。(摘要截选至250词)

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