title: Oral mask ventilation is more effective than face mask ventilation after nasal surgery.
abstract: OBJECTIVE
  To evaluate and compare the face mask (FM) and oral mask (OM) ventilation techniques during anesthesia emergence regarding tidal volume, leak volume, and difficult mask ventilation (DMV) incidence.
  
  
  METHODS
  Prospective, randomized, crossover study.
  
  
  METHODS
  Operating room, training and research hospital.
  
  
  METHODS
  American Society of Anesthesiologists physical status I and II adult patients scheduled for nasal surgery.
  
  
  METHODS
  Patients in group FM-OM received FM ventilation first, followed by OM ventilation, and patients in group OM-FM received OM ventilation first, followed by FM ventilation, with spontaneous ventilation after deep extubation. The FM ventilation was applied with the 1-handed EC-clamp technique. The OM was placed only over the mouth, and the 1-handed EC-clamp technique was used again. A child's size FM was used for the OM ventilation technique, the mask was rotated, and the inferior part of the mask was placed toward the nose.
  
  
  METHODS
  The leak volume (MVleak), mean airway pressure (Pmean), and expired tidal volume (TVe) were assessed with each mask technique for 3 consecutive breaths. A mask ventilation grade ≥3 was considered DMV.
  
  
  RESULTS
  DMV occurred more frequently during FM ventilation (75% with FM vs 8% with OM). In the FM-first sequence, the mean TVe was 249±61mL with the FM and 455±35mL with the OM (P=.0001), whereas in the OM-first sequence, it was 276±81mL with the FM and 409±37mL with the OM (P=.0001). Regardless of the order used, the OM technique significantly decreased the MVleak and increased the TVe when compared to the FM technique.
  
  
  CONCLUSIONS
  During anesthesia emergence after nasal surgery the OM may offer an effective ventilation method as it decreases the incidence of DMV and the gas leak around the mask and provides higher tidal volume delivery compared with FM ventilation.
authors.affiliation: Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. Electronic address: dilek.yazicioglu@hotmail.com.
authors.forename: Dilek
authors.initials: D
authors.lastname: Yazicioğlu
authors.affiliation: Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Ilkay
authors.initials: I
authors.lastname: Baran
authors.affiliation: Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Uzumcugil
authors.affiliation: Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ozturk
authors.affiliation: Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Gulten
authors.initials: G
authors.lastname: Utebey
authors.affiliation: Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: M Murat
authors.initials: MM
authors.lastname: Sayın
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000379:methods; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008397:Masks; D008875:Middle Aged; D059747:Nasal Surgical Procedures; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods; D013990:Tidal Volume; D055815:Young Adult
keywords: Equipment: mask; Surgery: nasal; Ventilation: artificial