Can Safe Anaesthetic Induction Be Predicted In Those With Acute Trismus?
Andrew Heard1, Richard Green2, David Lacquiere1, Paul Sillifant1 1 Royal Perth Hospital, Perth, Australia 2 Royal Bournemouth NHS Foundation Trust, Bournemouth, U.K. Background: Acute trismus can be caused by pain, muscle spasm, swelling or mechanical obstruction. Unfortunately the cause is not always obvious during preoperative airway assessment. In this pilot study we prospectively evaluated mandibular nerve block as a preoperative tool to identify patients with reversible causes, namely pain or spasm. Methods: Six patients with unilateral fractured mandibles and trismus received a mandibular nerve block prior to induction of general anaesthesia. Inter-incisor distance and pain scores were measured before, and 30 minutes after the blocks. Inter-incisor distance was measured again after induction of general anaesthesia. Results: There was an increase in maximal inter-incisor gap after the blocks (median distance in mm (IQR): pre-block 16.5 (15-23); post-block 34 (32-35); p = 0.027), a
