Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
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J. Oral Maxillofac. Surg. · Mar 2010
Randomized Controlled TrialAnalgesic effects of intra-articular morphine in patients with temporomandibular joint disorders: a prospective, double-blind, placebo-controlled clinical trial.
A number of reports have shown a direct analgesic effect of opioids by way of the peripheral receptors. Nevertheless, only a very few studies have reported using opioids in the temporomandibular joint (TMJ), and nearly all of them were connected to surgical patient groups. The present study was designed to evaluate the analgesic efficacy and safety of repeated intra-articular morphine applications compared with a local anesthetic and saline solution in the management of TMJ pain. ⋯ Independent of the applied substances, initial pain relief can be registered in the TMJ: either from the arthrocentesis effect or at least the placebo effect. Morphine at a dosage of 10 mg showed the best and most long-lasting analgesic efficiency. Morphine, in general (5 and 10 mg), and, with limitations, Carbostesin were more or less efficient for postoperative pain control but without distinct effects in the long term. With regard to our results, we can recommend intra-articular morphine application at a dose of 10 mg for pain management. Carbostesin showed no promising long-term effects.
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J. Oral Maxillofac. Surg. · Mar 2010
Randomized Controlled TrialMidazolam more effectively suppresses sympathetic activations and reduces stress feelings during mental arithmetic task than propofol.
The aim of the present study was to examine the effect of intravenous midazolam and propofol sedation on autonomic nervous activities during psychological stress, and whether these results are associated with changes in subjective stress feelings. ⋯ These results suggest that midazolam more effectively suppresses sympathetic nervous activation and reduces subjective stress feelings during a mental arithmetic task than propofol.
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J. Oral Maxillofac. Surg. · Mar 2010
Randomized Controlled TrialEpistaxis during nasotracheal intubation: a comparison of nostril sides.
It is commonly believed that for preventing epistaxis during nasotracheal intubation (NTI), the right nostril should be used. However, there is no real evidence as to which nostril should be used. In this study, we tested our hypothesis that epistaxis during NTI is more frequent and severe using the left nostril rather than the right, provided that patency appears equal on both sides of the nose. ⋯ Our data show that epistaxis during NTI is more frequent and severe with the left nostril than the right. Hence, when deciding which nostril to use for NTI, the right nostril should be used if patency appears equal on both sides of the nose.
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J. Oral Maxillofac. Surg. · Mar 2010
Simultaneous correction of bilateral temporomandibular joint ankylosis with mandibular micrognathia using internal distraction osteogenesis and 3-dimensional craniomaxillofacial models.
The present study evaluated the simultaneous correction of bilateral temporomandibular joint ankylosis with mandibular micrognathia using internal distraction osteogenesis (DO) with the help of a 3-dimensional craniomaxillofacial model technique. ⋯ Bilateral temporomandibular joint ankylosis accompanied by mandibular micrognathia and obstructive sleep apnea and hypopnea syndrome can be corrected effectively by simultaneous internal DO. The application of preoperative simulation surgery using 3-dimensional craniomaxillofacial model has many advantages for planning the surgical method and precise operation. Our preliminary results have shown that it is a safe, effective, and feasible technique.