A comparison of the nasal mask and the nasopharygeal airway in paediatric chair dental anaesthesia

Abstract

SummaryThis study compared the quality of anaesthesia and surgical access afforded by two techniques for the administration of anaesthesia during paediatric chair dental procedures. A total of 50 ASA 1 paediatric day case patients were randomly assigned to receive anaesthesia through either the traditional Goldman nasal mask or through a nasopharyngeal airway. Patients in the nasal mask group were judged to have significantly worse airway patency (p = 0.0001) and significantly more episodes of airway obstruction (14 vs. 4; p = 0.0032) than those in the nasopharygeal airway group. Anaesthetic, surgical and oxygen saturation data did not differ significantly between the two groups. Operating conditions were universally graded as excellent in the nasopharyngeal airway group, while those in the nasal mask group were graded as excellent/good in only 79% of cases (p < 0.0001). These results suggest that better quality anaesthesia and operating conditions can be achieved by using a nasopharyngeal airway rather than the traditional nasal mask for the administration of anaesthesia to paediatric chair dental patients.Keywords Anaesthesia; dental. Equipment; nasopharyngeal airway, tracheal tube, nasal mask.. ..................................................................................... Correspondence to: Dr O. Bagshaw Accepted: 3 February 1997 Paediatric chair dental surgery is a challenge to both the anaesthetist and the surgeon. The children are outpatients, not previously assessed by an anaesthetist, unpremedicated and often frightened and uncooperative. The anaesthetist and the surgeon have to share the airway and the problems of airway obstruction, oxygen desaturation and poor surgical access are common [1, 2].The technique of using a nasopharyngeal airway for both the maintainance of airway patency and the administration of general anaesthesia is historically well described [3][4][5], but there have been no recent reports of its usefulness as an alternative to the nasal mask. Traditionally, the nasopharyngeal airway has been made from rubber and was of a fixed length, which varied depending on the size of the airway selected. Recently, we have been using this technique substituting disposable tracheal tubes for the rubber airway. These have the advantages of being single-use, the length can be readily altered and they can be easily connected to a standard anaesthetic breathing system. The aim of this study was to compare the quality of anaesthesia and surgical access afforded by these two techniques and to note any associated morbidity. MethodsLocal Ethics Committee approval for the study was obtained. The majority of children presenting for daycase chair dental surgery were eligible for inclusion in the study. Children requiring tracheal intubation for conservation work were not studied. Informed consent was obtained from a parent.A total of 50 ASA 1 children were randomly assigned to either the Nasal Mask group or the Nasopharyngeal 786ᮊ 1997 Blackwell Science Ltd Airway group. All patients were unprem...

A Randomised Controlled Study of Comparison of Intraocular Pressure and Haemodynamic Responses to Insertion of the I-Gel, Classical Laryngeal Mask Airway and Endotracheal Tube

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“…The rise in IOP after insertion of device was greater for the tracheal tube intubation group (18 In a similar study by Ismail et al, 22 they found that insertion of the I-GEL did not increase IOP. Insertion of an endotracheal tube increased IOP from 11.6±1.6 to 16.5±1.7 mmHg (p<0.001).…”

The reinforced laryngeal mask in paediatric outpatient dental surgery

“…The nasopharyngeal airway has been used to provide an airway in these patients [3]. The airway is then connected directly to the breathing circuit.…”

“…Children having outpatient dental extractions under general anaesthesia have often been managed with a nasal mask [1,2] or nasopharyngeal airway [3]. A single dose of an intravenous induction agent has also been used with the extractions being performed during the recovery period.…”

The effect of swabs soaked in bupivacaine and epinephrine for pain relief following simple dental extractionsin children

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