Comparing the feasibility of ventilation with Novel nasal PAP device with conventional facemask in patients receiving general anaesthesia

Mask ventilation is pivotal during general anaesthesia (GA) especially at induction, serving as the primary means of ventilation before securing a definitive airway. It encompasses two critical aspects: ensuring an airtight seal between the mask and the patient’s face to prevent gas leakage and maintaining an unobstructed upper airway. Despite this, patients are prone to airway obstruction. Using the 2-hand technique of mask ventilation and / or use of airway adjuncts such as oropharyngeal or nasopharyngeal airway might help relieve this obstruction.

Nasal mask ventilation directs inspired air through the nasal cavity, countering gravity’s influence on the soft palate and tongue, thereby maintaining upper airway patency. Consequently, direct nasal ventilation may offer improved ventilation efficacy and a more natural breathing pattern. Continuous positive airway pressure (CPAP), delivered via non-invasive ventilation masks not only prevent upper airway collapse but also are being used in the ICUs to ventilate patients and also pre-oxygenate before intubating the critically ill. Literature also suggests using the Rendell Becker Soucek mask and even paediatric facemasks can be used for nasal ventilation in children and edentulous patients but these do not provide positive airway pressure (PAP) and neither are specifically designed to give a perfect fit. Super NO2VATM is specifically designed for nasal ventilation and also has the advantage of providing positive pressure ventilation that would maintain patency of upper airway. This novel device has been introduced in the market for its use in obese patients with obstructive sleep apnoea who are posted for procedures under sedation. In this study, we are using this device for mask-ventilating patients at the start of general anaesthesia and trying to compare its effectiveness with that of the Conventional Facemask technique of ventilation