Effects Of Nasal Ventilation And Combined Oral-nasal Ventilation In Adult Patients During Induction Of General Anesthesia

object: By comparing the respiratory parameters with nasal versus combined oral-nasal mask ventilation in nonparalyzed apneic patiens during induction of general anesthesia.This study demonsrated that nasal mask ventilation produced more effective ventilation than combined oral-nasal mask even under suboptimized conditioned attaind without the benefit of lower jaw thrust and head extension.Methods: 100 patients who are in anesthesia intubations were chosen in the operating room of First Hospital of Jilin University and they are more than 18 years old. ASA classification was I-II class. Ensure patients awake, and were ventilated by mouth and nostrils well. Besides, they do not need ventilation. They were divided into two groups: group of nasal mask and oral-nasal mask ventilation. Patients who associated with cardiovascular disease, respiratory disease, cerebrovascular disease, and gastro esophageal reflux, and full stomach, emergency patients are not within the range of options. Patients who are due to illness or surgery needs before surgery or indwelling stomach tube enteral nutrition were excluded. After patients entered into room , veins in patients , routine monitoring of ECG, blood pressure, pulse oxygen saturation were turned on or after the mask deflated, with appropriate closure of mask to ensure closed good. Supine patients without pillow, make his head in the middle, without neck flexion and backward. Patients did three times deep breathing before induction of anesthesia, while inhaling 100% oxygen to ensure adequate reserve of oxygen in patients. Application of the induction of anesthesia with fentany3ug/kg, midazolam 0.1mg/kg, cis atracurium 0.15mg/kg, etomidate 0.3mg/kg. Ventilate mask after the disappearance of spontaneous breathing in patients, with volume-control mode, tidal volume 10ml/kg, respiratory rate 14 beats / min, oxygen flow 6L/min, suction expiratory ratio of 1:1. First, application of nose-oral ventilation 5-10 times; Observation of thoracic fluctuations, tidal volume, airway pressure, end-tidal carbon dioxide; while making a record of heart rate, oxygen saturation, hemodynamics of blood pressure. Then, do an observation of above target after the replacement for the nasal mask ventilation. Record the highest value and lowest value of the above target repeatedly and statutory, then, chose its average. Ensure that pulse oxygen saturation no less than 95% during the process. If poor ventilation or lower blood oxygen saturation trends is found, replace the mask for ventilation immediately.Result: compared nose-mouth mask ventilation group with the joint mask ventilation group, patients in the two groups, heart rate: (69.2±9.1; 69.16± 8.83) times / min, blood pressure: 70.1±9.3; 0.1±8.3 )mmHg, Oxygen saturation: (98.8±0.3; 98.8±0.3)%, p>0.05, There was no significant difference. while in nose-mouth mask group, end-tidal carbon dioxide: (24.62±8.01ml)higher than the group of combined oral-nasal mask ventilation in end-tidal carbon dioxide(5.05±7.07ml)p<0.01; There was a significant difference. Airway pressure (23.27±5.74cmH2O) lower than (38.57±12.92cmH2O)p<0.01; There was a significant difference.Conclusions: Patients with head in the middle, no application of method of holding up jaw; during anesthesia induction, compared nasal-mask ventilation with Combined oral-nasal mask ventilation, there are some differences existing in nasal-mask ventilation: Low airway pressure; High tidal volume; high End- tidal carbon dioxide. It is clearly that it is more effective with the application of nasal-mask ventilation compared with combined oral-nasal mask ventilation. It also has Good guide and reference for the patients, especially for the patients who have sleep apnea syndrome, Temporomandibular joint fixed, Pituitary acromegaly, limited Neck activity.