Optimising the unprotected airway with a prototype Jaw-Thrust-Device--a prospective randomised cross-over study

Anaesthesia. 2009 Nov;64(11):1236-40. doi: 10.1111/j.1365-2044.2009.06059.x.

Abstract

Despite being a standard procedure during induction of anaesthesia, facemask ventilation can be a major challenge especially for inexperienced anaesthetists. We manufactured a Jaw-Thrust-Device designed to keep the patient's jaws in an optimised position, and thus to maintain the airway in a permanently patent state. Using a cross over design, we compared the influence of using the Esmarch manoeuvre (bimanual jaw-thrust), a nasopharyngeal airway, an oropharyngeal airway, or the Jaw-Thrust-Device on airway physiology in 50 healthy adults with body mass index < 35 kg.m(-2), undergoing standard facemask ventilation for routine induction of anaesthesia. The main study endpoints were expiratory tidal volumes, airway resistances, and gas flow rates. The Jaw-Thrust-Device was more effective in increasing expiratory tidal volumes and peak inspiratory flow than a standard Esmarch manoeuvre, and was more effective than both nasopharyngeal and oropharyngeal airways in decreasing airway resistance.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Airway Obstruction / prevention & control*
  • Anesthesia, Inhalation / instrumentation*
  • Cross-Over Studies
  • Equipment Design
  • Female
  • Head Movements
  • Hemodynamics
  • Humans
  • Intubation, Intratracheal / instrumentation
  • Intubation, Intratracheal / methods
  • Male
  • Masks
  • Middle Aged
  • Prospective Studies
  • Respiration, Artificial / instrumentation*
  • Respiratory Mechanics
  • Young Adult