Comparison of three methods in improving bag mask ventilation

Area of Science:

• Anesthesiology
• Geriatric Medicine
• Airway Management

Background:

• Aging populations present challenges in managing elderly patients, particularly regarding airway management due to increased edentulism.
• The optimal approach for bag-mask ventilation (BMV) in patients with dentures remains debated.

Purpose of the Study:

• To compare the effectiveness of different airway management strategies in elderly patients undergoing anesthesia.
• To evaluate the impact of leaving dentures in place versus removing them on BMV success.

Main Methods:

• A single-blind randomized clinical trial involving 300 patients (ASA class I-II, Mallampati I-II, age >55).
• Three groups were studied: dentures removed with gauze and oral airway (G), dentures and oral airway left in place (D), and dentures removed with only an oral airway (C).
• BMV success was defined by end-tidal carbon dioxide criteria.

Main Results:

• Successful BMV was achieved in 91% of patients in group G, 64% in group D, and 41% in group C.
• The differences in BMV success rates between the groups were statistically significant.
• Female patients showed a significantly higher successful BMV rate in group G compared to group C.

Conclusions:

• Leaving dentures in place during anesthesia induction can improve bag-mask ventilation in edentulous patients.
• Placing folded compressed gauze in the buccal space significantly enhances BMV compared to leaving dentures in place.