Tegarderm® Placement for Bag Mask Ventilation in the Bearded Patient

Not Applicable

Terminated

Brief Summary: Difficult Bag Mask Ventilation is well described in the anesthesiology literature, and bearded patients are likely to experience this phenomenon. This study involves application of a large and perforated Tegaderm® across the lower face of the bearded patient to quantify its effectiveness at improving mask ventilation in this anesthetized population.

Detailed Description: This study is a prospective crossover trial in bearded patients who will undergo elective or urgent surgery at the main operating rooms of the University of New Mexico Hospital.

It is planned to test the efficacy of the novel bag mask ventilation augmentation technique of placing a large perforated Tegaderm® over the mouth of bearded male patients in order to improve seal after induction of general anesthesia. The perforation is a diamond-shaped hole to be aligned with the patient's mouth. Patients will either start with Tegaderm application or without Tegaderm, and will then cross over to the other condition in order to be their own controls. The primary endpoint is to measure inspiratory and expiratory tidal volumes.

If shown efficacious this intervention would be an easy and cost-effective intervention to improve bag mask ventilation for bearded patients in the operating room and non-operating room environments alike.

Recruitment & Eligibility

Inclusion Criteria

Adult patients with perioral facial hair >5mm in length
Undergoing elective non-cardiac surgery with planned bag-mask ventilation during anesthesia induction

Exclusion Criteria

Known allergy to Tegaderm product and/or its adhesive
Emergency surgery
Active or unstable cardiac disease
ASA (American Society of Anesthesiologists) physical status ≥4
External or internal active airway obstruction from tumor, abscess, or laryngeal edema
Organic or non-organic oropharyngeal anatomical defects including history of radiation treatment to the neck
Moderate to severe acute and chronic restrictive or obstructive lung diseases, e.g. chronic obstructive pulmonary disease, asthma, etc.
Requirement for rapid sequence intubation, or known aspiration risk
Cervical spine injury
Previously documented difficult mask ventilation or intubation
BMI ≥50
Vulnerable populations: children, prisoners, pregnant patients, cognitively impaired adults

Arm && Interventions

Group	Intervention	Description
Bag-Mask Ventilation with Tegaderm	Tegaderm placement	Patients will receive bag-mask ventilation with Tegaderm placement
Bag-Mask Ventilation without Tegaderm	No Tegaderm	Patients will receive bag-mask ventilation without Tegaderm placement

Primary Outcome Measures

Name	Time	Method
Percent Air Leakage During Bag-mask Ventilation	<5 minutes	Leakage defined as difference in inspired and expired tidal volumes during bag-mask ventilation, as a percentage of inspired tidal volume.

Secondary Outcome Measures

Name	Time	Method
Resistance	<5 minutes	Airflow resistance during bag-mask ventilation
Peak Inspiratory Pressure	<5 minutes	Maximum air pressure observed during bag-mask ventilation