Comparing the efficacy of modified thenar eminence technique with conventional thenar eminence technique of mask ventilation during induction of general anaesthesia - A randomised crossover study.

Abstract

Mask ventilation is one of the important skills required for successful airway management. Following the induction of general anaesthesia, there could be airway obstruction due to fall back of the tongue or soft palate. This obstruction could be overcome by manoeuvring the mandible or inserting airways. The primary objective of the study was to compare the efficacy of modified thenar eminence technique of mask ventilation in improving expired tidal volume (VTE) over conventional thenar eminence technique and the secondary objective was to compare peak airway pressure (PMAX) and ease of mask ventilation between the two techniques. Seventy-six patients were randomised into group M and group C. In group M, the modified thenar eminence technique was performed for five consecutive breaths followed by conventional technique, and vice versa was followed in group C. In each breath, VTE, PMAX and end-tidal carbon dioxide were noted. Participants reported the ease of ventilation score using the Likert scale for each technique. VTE was significantly more in modified thenar eminence technique than conventional technique [mean ± standard deviation, 370 ± 55 ml versus 313 ± 50 ml, P = 0.01]. Ease of ventilation score [median 1.70 (interquartile range (1-2)) versus 2.3 (2-3), P = 0.01] showed that modified technique was easier compared to conventional technique. Modified thenar eminence technique of mask ventilation is superior to the conventional technique in terms of VTE and ease of ventilation in the unanticipated difficult airway.