This study aims to compare two different ways doctors hold a face mask to help the participant breathe during general anesthesia. The investigators are evaluating which method, the "C-E" or the "V-E" technique, works best.
If the participant chooses to take part, on the day of surgery, after anesthesia has been administered and the participant is asleep, the doctor will use one of these two mask-holding techniques to assist breathing for a short period. The investigators will measure how effectively the participant is breathing, check carbon dioxide levels, and record the doctors' assessment of how easy and comfortable each technique was for them. This study will not alter any other aspect of the surgery or recovery.
Adult patients over 18 years old
Scheduled for elective surgery
Require general anesthesia
Consent to participate in the study
Presence of predictors of difficult ventilation: presence of a beard, --obstructive sleep apnea/hypopnea syndrome
Anticipated difficult airway
Classified as ASA IV or higher
Oxygen saturation less than 92% upon admission
Parallel
V-E facial mask ventilation maneuver
Procedure/SurgeryThe V-E maneuver is achieved by placing the thumbs and thenar eminence of each hand on the sides of the mask, creating a "V" shape, while the rest of the fingers perform a jaw thrust described as an "E" shape. This will be performed after anesthetic induction when the patient is unconscious and apneic. The C-E maneuver is achieved by placing the thumb and index finger of each hand on the mask in a "C" shape, while the third, fourth, and fifth fingers of both hands perform a jaw thrust towards the mask in an "E" shape. This will also be performed after anesthetic induction when the patient is unconscious and apneic.
C-E facial mask ventilation maneuver
Procedure/SurgeryThe C-E maneuver is achieved by placing the thumb and index finger of each hand on the mask in a "C" shape, while the third, fourth, and fifth fingers of both hands perform a jaw thrust towards the mask in an "E" shape. This will also be performed after anesthetic induction when the patient is unconscious and apneic.
Ventilation ml/kg
Average ventilation in milliliters per kilogram of body weight for seven ventilations recorded on the anesthesia machine at the end of expiration.
Average CO2 mmHg
Average CO2 in mmHg for seven ventilations recorded on the anesthesia machine at the end of expiration.
Ineffective ventilation
Proportion of ineffective ventilation, defined as ventilation less than 1.5 ml/kg.
Operator satisfaction.
Operator's perceived ease of use, on a Likert scale from 1 to 5, with 1 being very easy and 5 being very difficult.
Hypoxemia
defined as SpO2 less than 92%
Adverse events by group.
Adverse events by group.
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