[The First Successful Application of a Mask with a Left Side Slit for Passing the Trunk of an Endoscope In Situ and...

Sedation in patients during gastrointestinal (GI) endoscopy involves the risk of respiratory depression. Ventilation support with a conventional face mask without removing an endoscope is impossible. We devised a ventilation mask with a slit and membranous valve on the left side wall and the circular upper end enabling to pass the trunk of an endoscope in situ, based on an idea published in the Japanese Journal of Anesthesia "Masui" 2013; 62: 105-8. An 82-year-old woman was scheduled for GI endoscopy for severe abdominal pain. An endoscope was inserted into her GI tract through the mouth after midazolam 1.5 mg i.v. Soon after the examination began, she developed respiratory depression, and her SpO2 gradually decreased to 84%, despite oxygen insufflated around the nose and mouth. The new slit mask was applied without removing the endoscope, and respiratory support was started by bag-valve method. Her SpO2 recovered and remained above 95% thereafter as the endoscopic examination continued. The side slit mask offers important advantages allowing its application in situ after an endoscope being inserted and by enabling positive pressure ventilation without interrupting the endoscopic procedure.