Comparison of intraoral mask and classic face mask in terms of ventilation success and practitioners' workload assessments: A randomised crossover study.

AIM: Providing effective ventilation of the unconscious patient is an essential skill in every specialty dealing with airway management. In this randomised crossover study aimed to compare intraoral and classic face mask in terms of ventilation success of patients, practitioners' workload and anxiety assessments. Also we analysed potential risk factors of difficult mask ventilation for both masks. METHODS: In all, 24 anaesthesiology residents and 12 anaesthesiologists participated in the study. Each of the practitioners ventilated four patients with both masks at settled pressure and frequency. Practitioners rated their workload and anxiety related to masks with National Aeronautics and Space Administration Task Load Index score and State Trait Anxiety Inventory scale. Ventilation success was evaluated with Han scale, expiratory tidal volume and leak volume. We analysed potential risk factors of difficult mask ventilation with anthropometric characteristics and STOP-Bang score. RESULTS: Ventilation success rate was superior with intraoral mask comparing to classic face mask in terms of successful ventilation (P = .000) and tidal volume (P = .000). Leak volume in in intraoral mask ventilation was significantly lower than classic face mask (P = .000). Difficult mask ventilation risk factors for classic face mask were high weight (P = .011), neck circumference (95% CI, OR = 1.180, P = .002), Mallampati score (P = .029) and high risk of OSAS (P = .001). Difficult mask ventilation risk factors for intraoral mask were high body mass index (95% CI, OR 1.162 P = .006) and Mallampati score (P = .043). The anxiety ratings of practitioners were similar between two masks. The workload rating is higher with intraoral mask comparing to classic face mask. CONCLUSION: Intraoral mask may be an effective alternative device for bag-valve mask ventilation.

Comparison of continuous interscalene block and subacromial infusion of local anesthetic for postoperative analgesia after open shoulder surgery.

PURPOSE: This study compared the efficacy of continuous interscalene block (CISB) and subacromial infusion of local anesthetic (CSIA) for postoperative analgesia after open shoulder surgery. METHODS: This randomized, prospective, double-blinded, single-center study included 40 adult patients undergoing open shoulder surgery. All patients received a standardized general anesthetic. The patients were separated into group CISB and group CSIA. A loading dose of 40 mL 0.25% bupivacaine was administered and patient-controlled analgesia was applied by catheter with 0.1% bupivacaine 5 mL/h throughout 24 h basal infusion, 2 mL bolus dose, and 20 min knocked time in both groups postoperatively. Visual analog scale (VAS) scores, additional analgesia need, local anesthetic consumption, complications, and side effects were recorded during the first 24 h postoperatively. The range of motion (ROM) score was recorded preoperatively and in the first and third weeks postoperatively. RESULTS: A statistically significant difference was determined between the groups in respect of consumption of local anesthetic, VAS scores, additional analgesia consumption, complications, and side effects, with lower values recorded in the CISB group. There were no significant differences in ROM scoring in the preoperative and postoperative third week between the two groups but there were significant differences in ROM scoring in the postoperative first week, with higher ROM scoring values in the group CISB patients. CONCLUSION: The results of this study have shown that continuous interscalene infusion of bupivacaine is an effective and safe method of postoperative analgesia after open shoulder surgery.