TMJ (Temporomandibular Joint) Replacement
- Access
- PIV x2
- Airway
- Nasal Intubation. Magill forceps, consider having the fiberoptic cart in the room.
- Induction
- Standard or TIVA. Propofol, Remifentanil (bolus 2 mcg/kg/min for 2 min), Phenylephrine in line Can also use paralysis (but OMFS may sometimes use facial nerve stimulator so full reversal will be needed)
- Maintenance
- TIVA (propofol/remifentanil/phenylephrine)
- Emergence
- Awake
- Antibiotics
- Cefazolin +/- Metronidazole
- Position
- Supine (arms will be tucked)
Notes
Usually administer 1 g Tranexamic acid
Check with Surgery on whether neuromonitoring/facial nerve stimulator.