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Published on: January 17, 2011

The effects of common airway maneuvers on airway pressure and flow in children undergoing adenoidectomies

Heinz Bruppacher1, Adrian Reber, Jürg P Keller

  • 1Division of Pediatric Anesthesia, University Children's Hospital Beider Basel, Switzerland.

Anesthesia and Analgesia
|June 24, 2003
PubMed

Insights

In anesthetized children with adenoidal hyperplasia, the jaw thrust maneuver, with or without CPAP, most effectively improved airway patency and ventilation compared to chin lift maneuvers.

Area of Science:

  • Anesthesiology
  • Pediatric Airway Management
  • Respiratory Physiology

Background:

  • Upper airway obstruction is common in anesthetized, spontaneously breathing children, particularly those with adenoidal hyperplasia.
  • Airway patency maneuvers like chin lift (CL), jaw thrust (JT), and continuous positive airway pressure (CPAP) are frequently employed.
  • Evaluating the comparative efficacy of these maneuvers is crucial for optimizing pediatric airway management.

Purpose of the Study:

  • To compare the efficacy of chin lift (CL) and jaw thrust (JT) maneuvers, with and without continuous positive airway pressure (CPAP), in improving airway patency and ventilation in children undergoing adenoidectomy.

Main Methods:

  • Sixteen children (aged 2-9 years) undergoing adenoidectomy were studied under sevoflurane anesthesia.
  • Mask, oropharyngeal, and esophageal pressures, along with flows, were measured during spontaneous breathing.
  • Maximal pressure differences during inspiration were calculated before and during CL and JT maneuvers, with and without CPAP (5 cm H2O).

Main Results:

  • All airway maneuvers reduced the pressure difference between the mask and esophagus (P < 0.05).
  • Chin lift (CL) did not significantly alter the mask-to-oropharynx pressure difference.
  • Jaw thrust (JT), with or without CPAP, significantly improved minute ventilation and maximal inspiratory peak flow (P > 0.05).

Conclusions:

  • While CL may offer some improvement, JT, with or without CPAP, demonstrated superior effectiveness in overcoming upper airway obstruction in this pediatric population.
  • The jaw thrust maneuver is the most effective intervention for enhancing airway patency and ventilation in children with adenoidal hyperplasia during anesthesia.
Abstract

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