Comparison of the Effectiveness of Two-Handed Mask Ventilation Techniques (C-E versus V-E) in Obese Patients Requiring General Anesthesia in an Indian Population

BACKGROUND: Two-handed mask ventilation techniques are often used in cases of difficult mask ventilation scenarios. A comparison of two methods of two-handed techniques in terms of tidal volume was undertaken in the context of the obese population. AIMS AND OBJECTIVES: To determine and compare the effectiveness of mask ventilation in obese Indian adult subjects by using either the C-E technique or the V-E technique after induction of general anaesthesia. MATERIAL AND METHODS: This was a randomised interventional study conducted on eighty obese patients. They were randomized into Group A ventilated with C-E technique and Group B with V-E technique. Expired tidal volume (VTe), Peak inspiratory pressure (PIP), SpO(2), EtCO(2) and vital signs were noted. RESULTS: The BMI and hemodynamic parameters were comparable between the two groups. The expired tidal volume of 702 ± 77 mL with the V-E technique was significantly more than the C-E technique, which was 492 ± 71 mL. The ventilatory failure rate with the C-E technique was 15% and 0% with the V-E technique. There was no significant difference between the peak airway pressures for the two techniques: 20.3 ± 1.5 mm H(2)O for Group A and 20.5 ± 1.2 mm H(2)O for Group B. CONCLUSIONS: Mask ventilation with the two-handed V-E technique is associated with better tidal volumes and reduced failure rates in the obese population. So the V-E technique should be attempted first as a rescue measure in obese adult patients if the return of spontaneous breathing and tracheal intubation is impossible.