Comparison of intra-oral mask and classic face mask in terms of ventilation success and practitioners’ work load assessments: a randomized crossover study

Abstract

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