Comparison of nasal and face mask ventilation in anaesthetised obese adults: A randomised controlled study
Background and Aims: The use of a face mask while inducing general anaesthesia (GA) in obese patients is often ineffective in providing adequate ventilation. Although nasal mask ventilation has demonstrated effectiveness for continuous positive airway pressure (CPAP) in obese patients with obstructi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2024;volume=68;issue=3;spage=267;epage=272;aulast=Singh |
| _version_ | 1797246479760359424 |
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| author | Gyan Singh Neeru Luthra Richa Jain Anju Grewal Shubham Garg Livleen Deep Mann |
| author_facet | Gyan Singh Neeru Luthra Richa Jain Anju Grewal Shubham Garg Livleen Deep Mann |
| author_sort | Gyan Singh |
| collection | DOAJ |
| description | Background and Aims: The use of a face mask while inducing general anaesthesia (GA) in obese patients is often ineffective in providing adequate ventilation. Although nasal mask ventilation has demonstrated effectiveness for continuous positive airway pressure (CPAP) in obese patients with obstructive sleep apnoea (OSA), it has not yet been applied to the induction of anaesthesia. This study evaluated the efficacy of nasal mask ventilation against standard face mask ventilation in anaesthetised obese patients with body mass index (BMI)>25 kg/m2. Methods: Ninety adult patients with BMI >25 kg/m2 were randomly assigned to receive either facemask (Group FM) or nasal-mask (Group NM) ventilation during induction of GA. Expired tidal volume (VtE), air leak, peak inspiratory pressure (PIP), plateau pressure (PPLAT), oxygen saturation (SpO2), and end-tidal carbon dioxide (EtCO2) were recorded for10 breaths, and their mean was analysed. Results: The mean (standard deviation) VtE measured was not significantly higher in Group NM [455.98 (55.64) versus 436.90 (49.50) mL, P = 0.08, degree of freedom (df):88, mean difference (95% confidence interval [CI]) −19.08 (−41.14, 2.98) mL]. Mean air-leak [16.44 (22.16) versus 31.63 (21.56) mL, P = 0.001, df: 88, mean difference 95%CI: 15.19 (6.03,24.35)], mean PIP [14.79 (1.39) versus 19.94 (3.05) cmH2O, P = 0.001, df: 88, mean difference, 95%CI: 5.15 (4.16, 6.14)], and mean PPLAT [12.04 (1.21) versus 16.66 (2.56) cmH2O, P = 0.001, df: 88, mean difference 95% CI: 4.62 (3.78, 5.45)] were significantly lower in Group NM. EtCO2, SpO2, and haemodynamic measurements were similar between the two groups. Conclusion: Nasal mask ventilation is an effective ventilation method and can be used as an alternative to face mask ventilation in anaesthetised obese adults with BMI>25 kg/m2. |
| first_indexed | 2024-04-24T19:43:27Z |
| format | Article |
| id | doaj.art-cc1c1a63907f469b8aa87c079b728678 |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-04-24T19:43:27Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-cc1c1a63907f469b8aa87c079b7286782024-03-25T10:27:48ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172024-01-0168326727210.4103/ija.ija_404_23Comparison of nasal and face mask ventilation in anaesthetised obese adults: A randomised controlled studyGyan SinghNeeru LuthraRicha JainAnju GrewalShubham GargLivleen Deep MannBackground and Aims: The use of a face mask while inducing general anaesthesia (GA) in obese patients is often ineffective in providing adequate ventilation. Although nasal mask ventilation has demonstrated effectiveness for continuous positive airway pressure (CPAP) in obese patients with obstructive sleep apnoea (OSA), it has not yet been applied to the induction of anaesthesia. This study evaluated the efficacy of nasal mask ventilation against standard face mask ventilation in anaesthetised obese patients with body mass index (BMI)>25 kg/m2. Methods: Ninety adult patients with BMI >25 kg/m2 were randomly assigned to receive either facemask (Group FM) or nasal-mask (Group NM) ventilation during induction of GA. Expired tidal volume (VtE), air leak, peak inspiratory pressure (PIP), plateau pressure (PPLAT), oxygen saturation (SpO2), and end-tidal carbon dioxide (EtCO2) were recorded for10 breaths, and their mean was analysed. Results: The mean (standard deviation) VtE measured was not significantly higher in Group NM [455.98 (55.64) versus 436.90 (49.50) mL, P = 0.08, degree of freedom (df):88, mean difference (95% confidence interval [CI]) −19.08 (−41.14, 2.98) mL]. Mean air-leak [16.44 (22.16) versus 31.63 (21.56) mL, P = 0.001, df: 88, mean difference 95%CI: 15.19 (6.03,24.35)], mean PIP [14.79 (1.39) versus 19.94 (3.05) cmH2O, P = 0.001, df: 88, mean difference, 95%CI: 5.15 (4.16, 6.14)], and mean PPLAT [12.04 (1.21) versus 16.66 (2.56) cmH2O, P = 0.001, df: 88, mean difference 95% CI: 4.62 (3.78, 5.45)] were significantly lower in Group NM. EtCO2, SpO2, and haemodynamic measurements were similar between the two groups. Conclusion: Nasal mask ventilation is an effective ventilation method and can be used as an alternative to face mask ventilation in anaesthetised obese adults with BMI>25 kg/m2.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2024;volume=68;issue=3;spage=267;epage=272;aulast=Singhbody mass indexface maskgeneral anaesthesianasalobesetidal volumeventilation |
| spellingShingle | Gyan Singh Neeru Luthra Richa Jain Anju Grewal Shubham Garg Livleen Deep Mann Comparison of nasal and face mask ventilation in anaesthetised obese adults: A randomised controlled study Indian Journal of Anaesthesia body mass index face mask general anaesthesia nasal obese tidal volume ventilation |
| title | Comparison of nasal and face mask ventilation in anaesthetised obese adults: A randomised controlled study |
| title_full | Comparison of nasal and face mask ventilation in anaesthetised obese adults: A randomised controlled study |
| title_fullStr | Comparison of nasal and face mask ventilation in anaesthetised obese adults: A randomised controlled study |
| title_full_unstemmed | Comparison of nasal and face mask ventilation in anaesthetised obese adults: A randomised controlled study |
| title_short | Comparison of nasal and face mask ventilation in anaesthetised obese adults: A randomised controlled study |
| title_sort | comparison of nasal and face mask ventilation in anaesthetised obese adults a randomised controlled study |
| topic | body mass index face mask general anaesthesia nasal obese tidal volume ventilation |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2024;volume=68;issue=3;spage=267;epage=272;aulast=Singh |
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