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Volume 2024, Issue 7
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Effective face mask ventilation is a life-saving skill. Loss of muscle tone under general anesthesia may lead to tongue fall and pharyngeal collapse and reduce the efficiency of face mask ventilation. It has been suggested that lateral head rotation may improve the efficiency of face mask ventilation. The aim of this study was to compare face mask ventilation in neutral and head-rotated positions in adult patients under general anesthesia.

This randomized crossover study was conducted on 42 patients of both genders, aged 18–60 years, who were randomly assigned to group NRN (face mask ventilation performed in neutral–rotated–neutral head positions for one minute each) and group RNR (face mask ventilation performed in rotated–neutral–rotated head positions for one minute each). The primary outcome was the expired tidal volume (VTE) measured in both head positions during pressure control mode of ventilation with a peak inspiratory pressure of 15 cmHO. Secondary outcomes included the number of patients with airway obstruction or low VTE during mask ventilation and the effects of age, height, Mallampati class, and airway obstruction or low VTE on VTE in the head-rotated position.

The mean VTE was significantly higher in the neutral position (637.93 ± 186.62 ml) compared to the head-rotated position (625.30 ± 183.52 ml) ( = 0.036). The VTE was comparable in group NRN and group RNR in neutral ( = 0.455) and head-rotated positions ( = 0.464). The incidence of airway obstruction was similar in both positions and no patient had low VTE during mask ventilation. Age, height, Mallampati class, and airway obstruction or low VTE in neutral position had no effect on VTE in the head-rotated position.

There was a significant decrease in the VTE in the rotated head position compared to the neutral head position during mask ventilation in patients under general anesthesia.

© 2024 Kumar, Bhalotra, Singh, licensee HBKU Press.
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2024-10-24
2024-11-01
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/content/journals/10.5339/jemtac.2024.35
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Evaluation of the effect of head rotation on face mask ventilation in adults under general anesthesia: A randomized, single-blind, crossover study
Journal of Emergency Medicine, Trauma and Acute Care 2024, 35 (2024); https://doi.org/10.5339/jemtac.2024.35
/content/journals/10.5339/jemtac.2024.35
/content/journals/10.5339/jemtac.2024.35
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  • Article Type: Research Article
Keyword(s): expired tidal volume, face mask ventilation, lateral head rotation and neutral position

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