Temporomandibular joint dysfunction following the use of a supraglottic airway device during general anaesthesia: a prospective observational study.

Supraglottic airway devices are commonly used to manage the airway during general anaesthesia. There are sporadic case reports of temporomandibular joint dysfunction and dislocation following supraglottic airway device use. We conducted a prospective observational study of adult patients undergoing elective surgery where a supraglottic airway device was used as the primary airway device. Pre-operatively, all participants were asked to complete a questionnaire involving 12 points adapted from the Temporomandibular Joint Scale and the Liverpool Oral Rehabilitation Questionnaire. Objective measurements included inter-incisor distance as well as forward and lateral jaw movements. The primary outcome was the inter-incisor distance, an accepted measure of temporomandibular joint mobility. Both the questionnaire and measurements were repeated in the postoperative period and we analysed data from 130 participants. Mean (SD) inter-incisor distance in the pre- and postoperative period was 46.5 (7.2) mm and 46.3 (7.5) mm, respectively (p = 0.521) with a difference (95%CI) of 0.2 (-0.5 to 0.9) mm. Mean (SD) forward jaw movement in the pre- and postoperative period was 3.6 (2.4) mm and 3.9 (2.4) mm, respectively (p = 0.018). Mean (SD) lateral jaw movement to the right in the pre- and postoperative period was 8.9 (4.1) mm and 9.1 (4.0) mm, respectively (p = 0.314). Mean (SD) lateral jaw movement to the left in the pre- and postoperative period was 8.8 (4.0) mm and 9.3 (3.6) mm, respectively (p = 0.008). The number of patients who reported jaw clicks or pops before opening their mouth as wide as possible was 28 (21.5%) vs. 12 (9.2%) in the pre- and postoperative period, respectively (p < 0.001) with a difference (95%CI) of 12.3% (6.7-17.9%). There was no significant difference in the responses to the other 11 questions or in the number of patients who reported pain in the temporomandibular joint area postoperatively. No clinically significant dysfunction of the temporomandibular joint following the use of supraglottic airway devices in the postoperative period was identified by either patient questionnaires or objective measurements.

Preparation and characterization of poly nano-cerium chloride for 99Mo production based on neutron activation reactions.

Different molar ratios of the cerium trichloride heptahydrate to isopropyl alcohol (1:2, 1:3 and 1:5) were studied to choose the optimum ratio, and studied the reaction temperature effect (80, 90 and 100 °C) to determine the optimum temperature for the preparation of poly nano cerium chloride (PNCC). The PNCC-1 was selected among the prepared PNCC batches based on the 99Mo sorption properties that confirms the feasibility of using it as a novel effective sorbent material. The structural properties and chemical composition were studied using different techniques and devices such as EDX, XRD, FESEM, FTIR, TGA, and DTA. The sorption capacity was found to be 450 ± 27 and 195 ± 11 mg/g PNCC-1 using the static and dynamic techniques, from 0.01 M NaOH to obtain about 55 and 75% 99mTc separation efficiency, respectively. The acceptability of the eluate 99mTc was investigated from the point of view of radiochemical, radionuclidic and chemical purity.