Providing effective ventilation of the unconscious patient during either resuscitation or general anaesthesia induction and wake-up period is an essential skill in every specialty dealing with airway management. Adequate mask ventilation has become an important focus in the difficult airway algorithms' various stages. 1,2 Although mask ventilation is life-saving and important, this topic has been given little coverage in the widespread scientific literature and book chapters on airway management. 3 Determining risk factors
Aim: Providing effective ventilation of the unconscious patient is an
essential skill in every specialty dealing with airway management. In
this randomized cross-over study aimed to compare intra-oral and classic
face mask in terms of ventilation success of patients, practitioners’
workload and anxiety assessments. Also we analyzed potential risk
factors of difficult mask ventilation for both masks. Methods: 24
anesthesiology residents and 12 anesthesiologists participated in the
study. Each of the practitioners ventilated 4 patients with both masks
at settled pressure and frequency. Practitioners rated their workload
and anxiety related to masks with National Aeronautics and Space
Administration Task Load Index score and State Trait Anxiety Inventory
scale. Ventilation success was evaluated with Han scale, expiratory
tidal volume and leak volume. We analyzed potential risk factors of
difficult mask ventilation with anthropometric characteristics and
STOP-BANG score. Results: Ventilation success rate was superior with
intraoral mask comparing to classic face mask in terms of Han Scale
(Easy mask ventilation percentage 84/144 (58.3%); 123/144 (85.4%);
respectively) and tidal volume (481.92±173.99; 430.85±154.87mL;
respectively). Leak volume in intraoral mask ventilation was
significantly lower than classic face mask (71.50±91.17 /159.38±146.31
respectively). Diffucult mask ventilation risk factors were high weight,
neck circumference, Mallampati score and STOP-BANG score>3
for classic face mask (at the utmost neck circumference 95% CI,
OR=1.180, p= 0.002) Risk factors were high body mass index and
Mallampati score for intraoral mask (at the utmost Body mass index 95%
CI, OR=1.162 p=0.006). The anxiety ratings of practitioners were similar
between two masks. The work-load rating is higher with intraoral mask
comparing to classic face mask. Conclusion: Intraoral mask may be an
effective alternative device for bag-valve mask ventilation.
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