AIRWAY DEVICE TO FACILITATE FACE MASK VENTILATION IN EDENTULOUS PATIENTS

摘要

ABSTRACT. US data shows the geriatric population constituting 14% of their population in 2013 and an increase up to 21% by the year 2050. With increasing age, challenges related to anesthesia increase due to the anatomical and physiological changes, and deterioration in all the organ systems including the airways.Oneof the predictorsto difficult bag and mask ventilationis a patient who is edentulous.Bag and mask ventilation isdifficult to perform in edentulousbecause of 2 reasons: 1) The oral contour and bulge which is necessary for a complete seal of the face mask is lost due to lack of teeth. This leads to persistent ;air leak around the mask hence making the ventilation f ineffective. 2) On administration of the muscle relaxant the tone of the buccal and pharyngeal muscles is/7 further deteriorated henceadding to|che airway insult .yfjv This problem has been dealt by methods that aim to reduce the air leak surrounding the face mask.lt has been done in the past by two ways : 1) Manipulate the face mask holding techniques : a) Wherein the facemask of a toddler size extends from the bridge of the nose to the maxillary alveolar lipor b) the caudal edge of the mask is placed above the lower lip and the neck is maintained in extension / 2) pulling the laxed sunken cheeks towards the maskTry to maintain the buccal bulge by either a) putting gauze pieces inside the mouth. b) keeping the dentures in during mask ventilation Our Invention: To overcome the problem of lax and sunken cheeks in edentulous patients, we have evolved an idea of a cuffed oropharyngeal airway which would have its cuff situated just distal to the bite block. Features of the airway: a) Rigid and smoothfiber material b) Bite block c) Availability in different sizes ;.:.. d) Cuff is pear shaped on both the sides so that it inflates and supports the immediate perioral area and simultaneously inflates maximum in the area of the cheeks. e) Spring loadd.one way valve regulated inflation line. . . . f) Cuff of different volumes for different sized airway g) Location of the cuff is just distal to the bite block, but not extending along the complete length I ADVANTAGES: a) Easy to use, as all the anesthesiologists and even the paramedics is trained to use the oropharyngeal airwa/;f b) The various maneuvers « pi - t r j |jxplained to seal the perioral leak are subjected to the skill; one possesses and requires practice. But just oral airway insertion and cuff inflation are relatively easy to perform. c) Cuff inflation would inflate the cheeks from inside the mouth hence reduction in the air leak around the facemask could be achieved. d) Also after administration of the muscle relaxants further loss of buccal or perioral muscle tone will not affect. e) Previously this was achieved by either putting gauze pieces inside the mouth to cover up the hollow cheeks or allowing the patient to wear the dentures during ventilation, but this could lead to incidences of aspiration, which could be avoided if the cuff is attached to the airway. f) It is a cheap and a disposable option.