Comparison of two hand C-E with hybrid mask ventilation techniques by novice airway providers in adult patients under general anaesthesia

The study will be conducted following approval from the Institutional Ethical and Scientific Review Committee. All enrolled patients will undergo a routine pre-anesthetic checkup, including medical history, physical examination, and airway assessment. Adequate fasting status will be ensured, and informed written consent will be obtained in a language understood by the patient.Participants will be randomly assigned to one of two groups (Group A or B) using computer-generated randomization, with group assignments concealed in sequentially numbered opaque envelopes.Upon arrival in the operating room, standard monitoring (pulse oximetry, 5-lead ECG, and non-invasive blood pressure) will be initiated, and baseline parameters including heart rate, systolic and diastolic blood pressure, and oxygen saturation will be recorded.An intravenous line will be secured, and premedication with IV midazolam (0.05 mg/kg) will be administered. Each patient will receive pre-oxygenation with 100 percent oxygen at 10 L/min for 3 minutes using a well-fitting transparent face mask.General anesthesia will be induced using IV propofol (2 mg/kg), IV fentanyl (2 mcg/kg), and IV vecuronium (0.1 mg/kg). Mechanical ventilation will be set in pressure-controlled mode (peak pressure 15 cm H2O, no PEEP, 12 breaths per minute, I:E ratio 1:2).A consultant anesthesiologist will perform mask ventilation for the first minute to confirm adequacy, then hand over to a novice airway provider (less than 3 years of experience) for 2 minutes of ventilation using the allocated technique—either two-hand C-E or hybrid (dominant hand C-E and non-dominant hand thenar eminence). An independent observer will record parameters such as exhaled tidal volume and oxygen saturation.If oxygen saturation drops below 94 percent or there is any hemodynamic instability, the consultant anesthesiologist will intervene immediately to ensure patient safety. After the study period, the anesthesiologist will proceed with standard care.Study Aim is to compare the effectiveness of the two-hand C-E technique and the hybrid mask ventilation technique when performed by novice airway providers in adult patients under general anesthesia.