Document Detail


Nasal ventilation is more effective than combined oral-nasal ventilation during induction of general anesthesia in adult subjects.
MedLine Citation:
PMID:  18497599     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The authors hypothesized that nasal mask ventilation may be more effective than combined oral-nasal mask ventilation during induction of general anesthesia. They tested this hypothesis by comparing the volume of carbon dioxide removed per breath with nasal versus combined oral-nasal mask ventilation in nonparalyzed, apneic, adult subjects during induction of general anesthesia. METHODS: Fifteen adult subjects receiving general anesthesia were ventilated first with a combined oral-nasal mask and then with only a nasal mask. The patient's head was maintained in a neutral position, without head extension or lower jaw thrust. Respiratory parameters were recorded simultaneously from both the nasal and oral masks regardless of ventilation approach. RESULTS: The volume of carbon dioxide removed per breath during nasal mask ventilation (median, 5.0 ml; interquartile range, 3.4-8.8 ml) was significantly larger than that during combined oral-nasal mask ventilation (median, 0.0 ml; interquartile range, 0.0-0.4 ml; P = 0.001); even the peak inspiratory airway pressure during nasal ventilation (16.7 +/- 2.7 cm H2O) was lower than that during combined oral-nasal ventilation (24.5 +/- 4.7 cm H2O; P = 0.002). The expiratory tidal volume during nasal ventilation (259.8 +/- 134.2 ml) was also larger than that during combined oral-nasal ventilation (98.9 +/- 103.4 ml; P = 0.003). CONCLUSIONS: Nasal mask ventilation was more effective than combined oral-nasal mask ventilation in apneic, nonparalyzed, adult subjects during induction of general anesthesia. The authors suggest that nasal mask ventilation, rather than full facemask ventilation, be considered during induction of anesthesia.
Authors:
Yafen Liang; William R Kimball; Robert M Kacmarek; Warren M Zapol; Yandong Jiang
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  108     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-23     Completed Date:  2008-06-17     Revised Date:  2009-03-05    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  998-1003     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia and Critical Care, MassachusettsGeneral Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General / instrumentation,  methods*
Carbon Dioxide / metabolism
Equipment Design
Female
Humans
Male
Masks*
Middle Aged
Mouth*
Nasal Cavity*
Respiration
Respiratory Mechanics
Tidal Volume
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide
Comments/Corrections
Comment In:
Anesthesiology. 2009 Feb;110(2):432; author reply 433   [PMID:  19164967 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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