The Effect of Leaving Dentures in Place on Bag-Mask Ventilation at Induction of General Anesthesia

Conlon, Niamh; Sullivan, Richard; Herbison, Peter; Zacharias, M; Buggy, Donal J.

doi:10.1213/01.ane.0000267257.45752.31

Cited by 38 publications

(18 citation statements)

References 8 publications

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“…If this was not achieved, it was then mandatory to use ancillary techniques to ensure adequate bag-mask ventilation. These techniques were defined as a secondary outcome and included the increasing of FGF to 6 L/min, closure of the APL valve to 30 cm H 2 O, and use of the oxygen flush device and two-person technique (the resident using two hands to secure the mask while an assistant squeezing the bag) [9]. …”

Section: Methodsmentioning

confidence: 99%

Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study

et al. 2011

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BackgroundRapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The purpose of our study was to determine success rates of bag-mask ventilation and tracheal intubation performed by emergency medicine residents before and after completing their anesthesiology curriculum.MethodsA prospective descriptive study was conducted at Nikoukari Hospital, a teaching hospital located in Tabriz, Iran. In a skills lab, a total number of 18 emergency medicine residents (post graduate year 1) were given traditional intubation and bag-mask ventilation instructions in a 36 hour course combined with mannequin practice. Later the residents were given the opportunity of receiving training on airway management in an operating room for a period of one month which was considered as an additional training program added to their Anesthesiology Curriculum. Residents were asked to ventilate and intubate 18 patients (Mallampati class I and ASA class I and II) in the operating room; both before and after completing this additional training program. Intubation achieved at first attempt within 20 seconds was considered successful. Successful bag-mask ventilation was defined as increase in ETCo2 to 20 mm Hg and back to baseline with a 3 L/min fresh gas-flow and the adjustable pressure limiting valve at 20 cm H2O. An attending anesthesiologist who was always present in the operating room during the induction of anesthesia confirmed the endotracheal intubation by direct laryngoscopy and capnography. Success rates were recorded and compared using McNemar, marginal homogeneity and paired t-Test tests in SPSS 15 software.ResultsBefore the additional training program in the operating room, the participants had intubation and bag-mask ventilation success rates of 27.7% (CI 0.07-0.49) and 16.6% (CI 0-0.34) respectively. After the additional training program in the operating room the success rates increased to 83.3% (CI 0.66-1) and 88.8% (CI 0.73-1), respectively. The differences in success rates were statistically significant (P = 0.002 and P = 0.0004, respectively).ConclusionsThe success rate of emergency medicine residents in airway management improved significantly after completing anesthesiology rotation. Anesthesiology rotations should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

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Section: Methodsmentioning

confidence: 99%

Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study

et al. 2011

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“…The results showed no link between lack of teeth and mask ventilation; however, other studies have shown that mask ventilation is more difficult in edentulous patients. Several previous studies have described the difficulties experienced by elderly patients during mask ventilation (4,7,14,16,17). However, very few studies have investigated the insertion of laryngeal masks and the possible problems related to this process in patients in this age group (7,8).…”

Section: Discussionmentioning

confidence: 99%

A comparison of usage of the laryngeal mask UniqueTMin denticulate and edentulate geriatric patients

et al. 2017

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Background/aim: Mask ventilation in geriatric and edentulous patients can be ineffective or even impossible because of the shape inside the patients' cheeks. For patients for whom a mask cannot be used for long, the use of a laryngeal mask can ease the administration of anesthesia. The aim of this study was to compare the use of the laryngeal mask Unique TM in denticulate and edentulate patients aged over 65 years.Materials and methods: This prospective study included patients according to the American Society of Anesthesiologists I-III classification, aged 65 years or more. The patients were divided into two groups: a dentulous group (n = 33) and an edentulous group (n = 33). The success of the first attempt of insertion, ease of insertion, time taken to insert, and oropharyngeal leak pressure were measured. After insertion of the laryngeal mask Unique TM , a researcher who was unaware of whether the patients had teeth or not conducted an oropharyngeal leak test. Results:The success rate of inserting the laryngeal mask Unique TM on the first attempt was higher in the dentulous group than in the edentulous group. Ease of insertion, time taken to insert, oropharyngeal leak pressure, and laryngopharyngeal morbidity were similar for each group. Conclusion:In this study, successful insertion of the laryngeal mask Unique TM was higher in dentulous than in edentulous patients. We conclude that this effect could have important implications for anesthesiologists managing edentulous geriatric patients with supraglottic airway devices.

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“…This loss of structure creates a gap between the cheeks and the mask. 18,19 Using 2 hands to pull the patient's cheeks to oppose the mask during mask ventilation often helps minimize leak. Recreating structure can be achieved by leaving the dentures in place 18 or by packing the patient's cheeks with gauze, 20 although the latter risks foreign object obstruction or aspiration.…”

Section: Inadequate Seal At the Mask-patient Interfacementioning

confidence: 99%

Optimizing Mask Ventilation: Literature Review and Development of a Conceptual Framework

et al. 2015

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Mask ventilation is lifesaving, especially in cases of difficult intubation. Many publications have offered distinct techniques for optimizing mask ventilation. This article reviews currently available difficult mask ventilation literature and theory. We divide difficult mask ventilation into 3 broad categories based on etiology: inadequate mask seal, increased airway resistance, and decreased respiratory compliance. Published strategies for overcoming difficulty are presented and organized by etiology.

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The Effect of Leaving Dentures in Place on Bag-Mask Ventilation at Induction of General Anesthesia

Abstract: We conclude that bag-mask ventilation is easier in edentulate patients when their dentures are left in situ during induction of general anesthesia.

Cited by 38 publications

References 8 publications

Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study

Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study

A comparison of usage of the laryngeal mask UniqueTMin denticulate and edentulate geriatric patients

Optimizing Mask Ventilation: Literature Review and Development of a Conceptual Framework

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