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Comparative evaluation of one-handed versus two-handed mask holding techniques in children during inhalational

Dinesh K Choudhry1, B Randall Brenn1, Karen Sacks2

  • 1Shriners Hospital for Children, Philadelphia, Pennsylvania, USA.

Paediatric Anaesthesia
|December 19, 2020
PubMed

Insights

Two-handed mask airway is superior to one-handed mask airway for children undergoing inhalational anesthesia, improving airway patency. This finding was consistent regardless of anesthetic depth.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Airway Management

Background:

  • Mask airway management is crucial during pediatric anesthesia.
  • Obstructive sleep apnea (OSA) in children presents unique airway challenges.
  • Adenotonsillar hypertrophy is a common cause of pediatric OSA.

Purpose of the Study:

  • To compare the efficacy of two-handed versus one-handed mask airway techniques.
  • To evaluate airway patency during inhalational induction of anesthesia in children.
  • To assess the impact of anesthetic depth on mask airway effectiveness.

Main Methods:

  • Randomized, two-period, crossover study involving 60 children (1-8 years) with OSA.
  • Comparison of one-handed and two-handed mask airway techniques for 30 seconds each.
  • Respiratory inductance plethysmography used to record work of breathing, phase angle, and labored breathing index.

Main Results:

  • Two-handed airway demonstrated superior airway patency compared to one-handed.
  • One-handed airway was associated with increased phase angle and labored breathing index.
  • Minute ventilation and tidal volume were significantly lower with the one-handed technique.

Conclusions:

  • Two-handed mask airway provides superior airway patency in children with OSA undergoing anesthesia.
  • The effectiveness of the two-handed technique was not influenced by anesthetic depth.
  • This technique is recommended for improved airway management in this patient population.
Abstract

Keywords:
ageairwaychilddrugsinduction of anesthesiainhaled agentssevoflurane

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