RESUMO
Objective To evaluate the efficacy of WEI NASAL JET for supraglottic ventilation before tracheal intubation in the patients with tooth loss.Methods Sixty patients of both sexes with tooth loss (more than 8 teeth missing),aged 67-83 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,with Mallampati classification Ⅰ-Ⅲ,with body mass index of 18-25 kg/m2,undergoing surgery with general anesthesia,were divided into 2 groups (n =30 each) using a random number table method:WEI NASAL JET group (S group) and mask group (M group).After the end of anesthesia induction,WEI NASAL JET was inserted via the nasal cavity to perform supraglottic ventilation in group S,and two-hand buckle mask was performed in group M,and the patients were tracheally intubated after 5-min ventilation.At 5min spontaneous breathing after nitrogen removal by oxygen supply,1,2,3 and 4 min after no spontaneous breathing and immediately after intubation (T5),ultrasound was used to measure the amplitude of diaphragm motion induced by respiratory movement,and blood gas analysis was performed to record the development of pH value＜7.30,SpO2＜90％ and fluctuation in mean arterial pressure and heart rate ≥30％ of baseline before operation.The development of ventilation-related complications was also recorded.Results Compared with group M,the amplitude of diaphragm motion induced by respiratory movement was significantly increased at T1-5,PaO2was increased at T2-5,PaCO2 and PETCO2 were decreased at T3-5,the incidence of sore throat and nasal mucosal bleeding was increased,the incidence of gingiva injury and flatulence was decreased (P ＜ 0.05),and no significant change was found in the incidence of fluctuation in mean arterial pressure and heart rate ≥30％ of baseline in group S (P＞0.05).The pH value＜7.30 and SpO2＜90％ were not found in two groups.Conclusion WEI NASAL JET can provide satisfactory supraglottic ventilation efficacy before tracheal intubation with good safety in the patients with tooth loss.
RESUMO
Objective@#To evaluate the efficacy of WEI NASAL JET for supraglottic ventilation before tracheal intubation in the patients with tooth loss.@*Methods@#Sixty patients of both sexes with tooth loss (more than 8 teeth missing), aged 67-83 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, with Mallampati classificationⅠ-Ⅲ, with body mass index of 18-25 kg/m2, undergoing surgery with general anesthesia, were divided into 2 groups (n=30 each) using a random number table method: WEI NASAL JET group (S group) and mask group (M group). After the end of anesthesia induction, WEI NASAL JET was inserted via the nasal cavity to perform supraglottic ventilation in group S, and two-hand buckle mask was performed in group M, and the patients were tracheally intubated after 5-min ventilation.At 5-min spontaneous breathing after nitrogen removal by oxygen supply, 1, 2, 3 and 4 min after no spontaneous breathing and immediately after intubation (T5), ultrasound was used to measure the amplitude of diaphragm motion induced by respiratory movement, and blood gas analysis was performed to record the development of pH value<7.30, SpO2<90% and fluctuation in mean arterial pressure and heart rate ≥30% of baseline before operation.The development of ventilation-related complications was also recorded.@*Results@#Compared with group M, the amplitude of diaphragm motion induced by respiratory movement was significantly increased at T1-5, PaO2was increased at T2-5, PaCO2 and PETCO2 were decreased at T3-5, the incidence of sore throat and nasal mucosal bleeding was increased, the incidence of gingiva injury and flatulence was decreased (P<0.05), and no significant change was found in the incidence of fluctuation in mean arterial pressure and heart rate ≥30% of baseline in group S (P>0.05). The pH value<7.30 and SpO2<90% were not found in two groups.@*Conclusion@#WEI NASAL JET can provide satisfactory supraglottic ventilation efficacy before tracheal intubation with good safety in the patients with tooth loss.
RESUMO
Patients who lost posterior teeth due to periodontitis or dental caries have collapsed vertical dimension, unstable occlusion and change of the mandibular position. In particular, patients in orthognathic surgery, clinician should re-establish the pre-operative stable position of mandibular condyle in articular fossa and favorable vertical dimension for high post-operative stability of mandible. Therefore, interdisciplinary approach and co-operation, including prosthetics, orthodontics, oral and maxillofacial surgeon, from diagnosis and treatment plan is important to get a good outcome. This case report was patients who had collapsed occlusal plane due to severe dental caries on maxillary molars with skeletal Class III malocclusion. Before orthognathic surgery, resetting of maxillary occlusal plane with temporary removable denture was performed. Then successful multidisciplinary approach was done and lead to acceptable clinical outcome.