von Goedecke A, Mitterschiffthaler L, Paal P, Mitterlechner T, Wenzel V, Herff H
Department of Anesthesiology and Critical Care Medicine, County Hospital Steyr, Steyr, Austria.
Anaesthesia. 2009 Nov;64(11):1236-40. doi: 10.1111/j.1365-2044.2009.06059.x.
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.
尽管面罩通气是麻醉诱导期间的标准操作，但它可能是一项重大挑战，尤其是对于缺乏经验的麻醉医生而言。我们制造了一种下颌前推装置，旨在使患者的下颌保持在最佳位置，从而使气道始终保持通畅状态。采用交叉设计，我们比较了在50名体重指数<35 kg.m(-2)的健康成年人中，使用埃斯马赫手法（双手下颌前推）、鼻咽通气道、口咽通气道或下颌前推装置对气道生理学的影响，这些成年人正在接受标准面罩通气以进行常规麻醉诱导。主要研究终点是呼气潮气量、气道阻力和气体流速。下颌前推装置在增加呼气潮气量和吸气峰值流速方面比标准的埃斯马赫手法更有效，并且在降低气道阻力方面比鼻咽通气道和口咽通气道都更有效。
