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Anesthetic Management of a Juvenile Hyaline Fibromatosis Patient With Trismus and Cervical Movement Limitation
Asako YasudaDDS, PhD,
Noriko MiyazawaMD, PhD,
Emiko InoueDDS,
Tomoaki ImaiDDS,
Yoshiki ShionoyaDDS, PhD, and
Kiminari NakamuraDDS, PhD
Article Category: Brief Report
Volume/Issue: Volume 68: Issue 2
Online Publication Date: Jun 29, 2021
DOI: 10.2344/anpr-68-01-04
Page Range: 117 – 118

a gingivectomy and excision of a lower lip mass under general anesthesia. Difficulties maintaining the airway during anesthetic management were anticipated due to trismus (15 mm between the upper and lower primary central incisors), limited cervical movement, and gingival hyperplasia. The patient's airway was easily maintained after slow mask induction with sevoflurane and oxygen. Adequate mask ventilation was confirmed, and the following drugs were intravenously administered: 0.08 mg atropine, 15 μg fentanyl, and 5 mg rocuronium bromide. Thereafter, continuous

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Tiagabine May Reduce Bruxism and Associated Temporomandibular Joint Pain
R. E. KastMD
Article Category: Case Report
Volume/Issue: Volume 52: Issue 3
Online Publication Date: Sep 01, 2005
DOI: 10.2344/0003-3006(2005)52[102:TMRBAA]2.0.CO;2
Page Range: 102 – 104

Bruxism is the jaw clenching or grinding of teeth that usually occurs during sleep. 1–5 It is synonymous with trismus when referring to tonic jaw clenching, and considerable jaw pain and tooth ischemic pain in particular can be generated by this form. Lifetime occurrence of at least some orofacial pain from a night of bruxing or daytime episodes of clenching or grinding, particularly at a time of unusual stress, approaches 100%. Point prevalence is estimated at 5–10% of the adult population, 5 6 and a minority of these individuals develop

Anesthetic Management of a Patient With Multiple Sclerosis
Naohiro OhshitaDDS, PhD,
Shoko GamohDDS, PhD,
Masahiko KanazumiDDS, PhD,
Masahiro NakajimaDDS, PhD,
Yoshihiro MomotaDDS, PhD, and
Yasuo M. TsutsumiMD, PhD
Article Category: Case Report
Volume/Issue: Volume 64: Issue 2
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-64-02-10
Page Range: 97 – 101

hospital. However, her TMJ adhered to the surrounding tissue immediately after the first TMJ mobilization surgery, and her trismus never improved. After the first TMJ mobilization, the patient had sustained damage to the inner ear due to surgical error, leading to right-sided deafness. The findings of the preoperative examinations were mostly normal with a few exceptions. Laboratory abnormalities included a hemoglobin value of 10.5 g/dL (normal 11.3–15.2 g/dL) and a total bilirubin value of 1.7 mg/dL (normal 0.2–1.2 g/dL). The electrocardiogram indicated a left

Figure 3 ; Meta-analysis of dexamethasone versus methylpredinisolone for trismus, with significance; I2 = 0.00, fixed-effect model used.
Saulo Gabriel Moreira Falci,
Thiago César Lima,
Carolina Castro Martins,
Cássio Roberto Rocha dos Santos, and
Marcos Luciano Pimenta Pinheiro
<bold>Figure 3</bold>
Figure 3

Meta-analysis of dexamethasone versus methylpredinisolone for trismus, with significance; I2 = 0.00, fixed-effect model used.

Severe Bradycardia Occurring After Assisted Mouth Opening: A Case Report
Yoshio HayakawaDDS,
Keiko Fujii-AbeDDS, PhD,
Takuya NakanoDDS, PhD,
Masayuki SuzukiDDS, and
Hiroshi KawaharaDDS, PhD
Article Category: Brief Report
Volume/Issue: Volume 69: Issue 1
Online Publication Date: Apr 04, 2022
DOI: 10.2344/anpr-68-03-07
Page Range: 46 – 48

CASE PRESENTATION The patient was a 46-year-old woman (height 159 cm; weight 59 kg; body mass index 20.5 kg/m 2 ) scheduled for intraoral scar revision under general anesthesia after previous coronoidectomy. She had trismus with a limited opening of 26 mm but no other significant medical or family history. No abnormalities were found during routine preoperative chest radiograph, electrocardiogram (ECG; heart rate, 64 bpm), or spirometry test. General anesthesia was induced using fentanyl 100 μg, remifentanil continuous infusion 0

; (a) Intraoral image showing significant trismus and carious lower right first molar. (b) Lateral view of the patient's face demonstrating mandibular micrognathia and retrognathia. (c) Limited mouth opening (∼1 cm) under general anesthesia.
Saori Taharabaru,
Takehito Sato, and
Kimitoshi Nishiwaki

(a) Intraoral image showing significant trismus and carious lower right first molar. (b) Lateral view of the patient's face demonstrating mandibular micrognathia and retrognathia. (c) Limited mouth opening (∼1 cm) under general anesthesia.

; Arrows indicate the timing each medication was administered. Ephedrine was given at 8 mg/bolus, phenylephrine at 0.05 mg/bolus, and dopamine at 2 μg/kg/min.
Naohiro Ohshita,
Shoko Gamoh,
Masahiko Kanazumi,
Masahiro Nakajima,
Yoshihiro Momota, and
Yasuo M. Tsutsumi

Arrows indicate the timing each medication was administered. Ephedrine was given at 8 mg/bolus, phenylephrine at 0.05 mg/bolus, and dopamine at 2 μg/kg/min.

Figure 1. ; Intraoperative electrocardiogram (ECG) strips. ECG strips at time of (A) induction of general anesthesia, (B) opening the patient's mouth, and (C) after administration of atropine.
Yoshio Hayakawa,
Keiko Fujii-Abe,
Takuya Nakano,
Masayuki Suzuki, and
Hiroshi Kawahara
<bold>Figure 1.</bold>
Figure 1.

Intraoperative electrocardiogram (ECG) strips. ECG strips at time of (A) induction of general anesthesia, (B) opening the patient's mouth, and (C) after administration of atropine.

Figure 2. ; The trigeminocardiac reflex pathway. Stimulation of the trigeminal sensory nerve branches produces neuronal signals that travel via afferent pathways through the Gasserian ganglion to the sensory nucleus of the trigeminal nerve and continue along short internuncial nerve fibers in the reticular formation to the motor nucleus of the vagus nerve to form the efferent pathway.1
Yoshio Hayakawa,
Keiko Fujii-Abe,
Takuya Nakano,
Masayuki Suzuki, and
Hiroshi Kawahara
<bold>Figure 2.</bold>
Figure 2.

The trigeminocardiac reflex pathway. Stimulation of the trigeminal sensory nerve branches produces neuronal signals that travel via afferent pathways through the Gasserian ganglion to the sensory nucleus of the trigeminal nerve and continue along short internuncial nerve fibers in the reticular formation to the motor nucleus of the vagus nerve to form the efferent pathway. 1

Difficult Airway Management in a Patient With Nicolaides-Baraitser Syndrome Who Had a Small Jaw and Limited Mouth Opening
Saori TaharabaruDDS,
Takehito SatoMD, and
Kimitoshi NishiwakiMD, PHD
Article Category: Brief Report
Volume/Issue: Volume 68: Issue 1
Online Publication Date: Apr 07, 2021
DOI: 10.2344/anpr-67-04-05
Page Range: 47 – 49

Management Techniques Her clinical evaluation revealed significant mandibular hypoplasia, retrognathia, and trismus with a maximum interincisal distance of ∼1 cm. She had also been formally diagnosed with obstructive sleep apnea and moderate adenoid hypertrophy. Therefore, she was considered high risk for being extremely difficult to mask ventilate and intubate. The developed anesthetic plan for this patient included a controlled mask induction to verify the ability to ventilate the patient prior to continuing. If mask