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Kapoor MC, Rana S, Singh AK, et al. Nasal mask ventilation is better than face mask ventilation in edentulous patients. J Anaesthesiol Clin Pharmacol. 2016;32(3):314-8doi: 10.4103/0970-9185.168262.
Kapoor, M. C., Rana, S., Singh, A. K., Vishal, V., & Sikdar, I. (2016). Nasal mask ventilation is better than face mask ventilation in edentulous patients. Journal of anaesthesiology, clinical pharmacology, 32(3), 314-8. https://doi.org/10.4103/0970-9185.168262
Kapoor, Mukul Chandra, et al. "Nasal mask ventilation is better than face mask ventilation in edentulous patients." Journal of anaesthesiology, clinical pharmacology vol. 32,3 (2016): 314-8. doi: https://doi.org/10.4103/0970-9185.168262
Kapoor MC, Rana S, Singh AK, Vishal V, Sikdar I. Nasal mask ventilation is better than face mask ventilation in edentulous patients. J Anaesthesiol Clin Pharmacol. 2016 Jul-Sep;32(3):314-8. doi: 10.4103/0970-9185.168262. PMID: 27625477; PMCID: PMC5009835.
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J Anaesthesiol Clin Pharmacol. 2016 Jul-Sep;32(3):314-8. doi: 10.4103/0970-9185.168262.

Nasal mask ventilation is better than face mask ventilation in edentulous patients.

Journal of anaesthesiology, clinical pharmacology

Mukul Chandra Kapoor, Sandeep Rana, Arvind Kumar Singh, Vindhya Vishal, Indranil Sikdar

Affiliations

  1. Department of Anaesthesiology, Command Hospital (CC), Lucknow, Uttar Pradesh, India.

PMID: 27625477 PMCID: PMC5009835 DOI: 10.4103/0970-9185.168262

Abstract

BACKGROUND AND AIMS: Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated.

MATERIAL AND METHODS: Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively evaluated. After induction of anesthesia and administration of neuromuscular blocker, lungs were ventilated with a standard anatomical face mask of appropriate size, using a volume controlled anesthesia ventilator with tidal volume set at 10 ml/kg. In case of inadequate ventilation, the mask position was adjusted to achieve best-fit. Inspired and expired tidal volumes were measured. Thereafter, the face mask was replaced by a nasal mask and after achieving best-fit, the inspired and expired tidal volumes were recorded. The difference in expired tidal volumes and airway pressures at best-fit with the use of the two masks and number of patients with inadequate ventilation with use of the masks were statistically analyzed.

RESULTS: A total of 79 edentulous patients were recruited for the study. The difference in expiratory tidal volumes with the use of the two masks at best-fit was statistically significant (P = 0.0017). Despite the best-fit mask placement, adequacy of ventilation could not be achieved in 24.1% patients during face mask ventilation, and 12.7% patients during nasal mask ventilation and the difference was statistically significant.

CONCLUSION: Nasal mask ventilation is more efficient than standard face mask ventilation in edentulous patients.

Keywords: Difficult mask ventilation; edentulous; face mask leak; nasal mask ventilation

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