Unilateral Temporomandibular Joint Dislocation after Jaw Thrust Maneuver

A 25-yr-old Iranian woman with incomplete abortion who was diagnosed and scheduled for dilatation and curettage procedures under general anesthesia. After premedication with Fentanyl 50µg and midazolam 2mg and enough pre-oxygenation, anesthesia was induced by sodium thiopental 250 mg and succynilcholine 60 mg with mask ventilation. After completion of procedure, the patient had a period of laryngospasm that we had to maneuvered head tilt and jaw thrust to insert an oral airway for effective ventilation. It was noted that the patient mouth was persistently open about 2 cm after removing of oral airway as the patients chin deviated to the left side. On palpation the right temporomandibular joint (TMJ) could be felt below the zygomatic arch and a diagnosis of unilateral mandibular dislocation was made. To confirm diagnosis plain radiography (anterior posterior skull projection) was immediately taken. TMJ dislocation was reduced by the anesthesiologist that placed his thumbs near the mandibular posterior teeth with his finger .Jaw dislocation after general anesthesia should be consider as an emergency situation that be harmful for the patients so everybody who work in the airway management must be alert to this complication .Actually, know to treat it.