Comparison of one-handed C-E technique and glass holding technique of mask ventilation in anesthetized, apnoeic paediatric patients

Abstract

Background: Successful and effective ventilation using a face mask is very basic, important and critical step in emergency resuscitation as well as in the operating room for pre-oxygenation of anesthetized apnoeic patients. Mask ventilation requires a good seal and a patent airway. Techniques for face mask ventilation include one-handed techniques and two-handed techniques. One-handed technique can be either classical C-E technique or glass holding technique. We aim to compare two one-handed techniques of mask holding in terms of delivered ventilation, mask leak and ease of performing. Method: All patients fulfilling inclusion and exclusion criteria were included after approval of the institutional ethics committee. After induction of general anaesthesia and confirming apnoea, patients with an odd serial number were first started with one-handed C-E technique then crossed over with glass holding technique while patients having even serial numbers were ventilated first with glass holding technique followed by the one-handed C-E technique. Expiratory tidal volume (VTe) and peak inspiratory pressure (PIP) and ease of ventilation for each breath in one minute were recorded. Results: VTe (mean ± SD) ml, Leak (mean ± SD) ml, PIP (mean ± SD) cmH2O was 94.94±25.22, 21.36±7.97, 18.05±2.99 and 101.78±28.18, 19.78±15.68, 16.52±1.95 for CE and Glass holding technique respectively. There is no significant difference between both the techniques in terms of analysed variables. (p-value > 0.05) Conclusion : Statistical analysis does not support that Glass holding technique is better than C-E technique in respect to studied variables. Still as results were comparable for both the groups, the Glass holding technique is a good alternative to C-E and other techniques of mask ventilation. Glass holding technique is very promising in view of ease of ventilation, decreasing procedural fatigue and reducing incidence and severity of tissue trauma, but further studies are required.