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

Alkan, Mikail; Aytaç, İsmail; Güven Aytaç, Betül; Ünal, Hidayet; Gürsul, Bahattin; Başkan, Semih; Postacı, Nadide Aysun; Göğüş, Nermin

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 Twenty four 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 succesful ventilation (p=0.000 ) and tidal volume (p=0.000). Leak volume in in intraoral mask ventilation was significantly lower than classic face mask (p=0000). Difficult mask ventilation risk factors for classic face mask were high weight (p=0.011), neck circumference (95% CI OR=1.180,p=0.002), Mallampati score (p=0.029) and high risk of OSAS (p=0.001) . Difficult mask ventilation risk factors for intraoral mask were high body mass index (95 % CI, OR 1.162 p=0.006) and Mallampati score (p=0.043). 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.