Gender difference in mask ventilation training of anesthesia residents

To investigate whether gender difference has an effect on an anesthesia resident's ability to perform successful mask ventilation.

Cohort study.

Surgical operation theater of a university-affiliated hospital.

839 ASA physical status I, II, and III patients undergoing general anesthesia performed by residents.

Mask ventilation was performed by 21 different anesthesia residents.

Difficult mask ventilation was defined as the inability of an unassisted resident to maintain oxygen saturation, significant gas flow leakage beneath the face mask, need to increase gas flow, no perceptible chest movement, assistance required using a two-handed mask ventilation technique, or use of the oxygen flush valve more than twice.

Instances of difficult mask ventilation were observed in 210 patients (25.0%), though all were adequately ventilated with a face mask. Difficult mask ventilation was observed significantly more often with female (29.8%) than male (20.0%) residents. Residents' gender was shown to be an independent risk factor for difficult mask ventilation.

Gender difference has an effect on the mask ventilation learning process, as it was more difficult for female residents to provide a tight air seal in the early stage of training.