Comparison of intra-oral mask and classic face mask in terms of
ventilation success and practitioners’ work load assessments: a
randomized crossover study
Aim: Providing effective ventilation of the unconscious patient
is an essential skill in every specialty dealing with airway management.
In this randomized cross-over study aimed to compare intra-oral and
classic face mask in terms of ventilation success of patients,
practitioners’ workload and anxiety assessments. Also we analyzed
potential risk factors of difficult mask ventilation for both masks.
Methods: 24 anesthesiology residents and 12 anesthesiologists
participated in the study. Each of the practitioners ventilated 4
patients with both masks at settled pressure and frequency.
Practitioners rated their workload and anxiety related to masks with
National Aeronautics and Space Administration Task Load Index score and
State Trait Anxiety Inventory scale. Ventilation success was evaluated
with Han scale, expiratory tidal volume and leak volume. We analyzed
potential risk factors of difficult mask ventilation with anthropometric
characteristics and STOP-BANG score.
Results: Ventilation success rate was superior with intraoral
mask comparing to classic face mask in terms of Han Scale (Easy mask
ventilation percentage 84/144 (58.3%); 123/144 (85.4%); respectively)
and tidal volume (481.92±173.99; 430.85±154.87mL; respectively). Leak
volume in intraoral mask ventilation was significantly lower than
classic face mask (71.50±91.17 /159.38±146.31 respectively).
Diffucult mask ventilation risk factors were high weight, neck
circumference, Mallampati score and STOP-BANG score>3 for
classic face mask (at the utmost neck circumference 95% CI, OR=1.180,
p= 0.002) Risk factors were high body mass index and Mallampati score
for intraoral mask (at the utmost Body mass index 95% CI, OR=1.162
p=0.006).
The anxiety ratings of practitioners were similar between two masks. The
work-load rating is higher with intraoral mask comparing to classic face
mask.
Conclusion: Intraoral mask may be an effective alternative
device for bag-valve mask ventilation.
Key words : Difficult mask ventilation; Face mask; Han scale;
Intraoral mask; STOP BANG score