Comparative study of newer mask ventilation Technique(thumb sealing and angle of mandible technique- tsam) with conventional thenar eminence Technique of mask ventilation during induction of General anesthesia - A randomized cross over study.

Mask ventilation is one of the necessary abilities required for successful airway management.

Maintenance of airway patency and oxygenation are major goals of mask ventilation. Difficult mask ventilation could happen in four out of 1000 patients. When the conventional mask ventilation is difficult, several alternative techniques have been described. One such technique is conventional thenar eminence. In this technique downward pressure is applied with thenar eminences of both hands while four fingers of each hand pull the jaw towards the mask, it leads to closure of mouth resulting in airway obstruction at the oropharynx. However, this obstruction could possibly be overcome by the use of an appropriately sized oro-pharyngeal airway.

This may not be successful in all patients. In newer mask ventilation technique four finger of both hands used at angle of mandible to provide upward pressure that lift the mandible relieve tongue fall and both thumbs provide downward and forward pressure nasal part of mask providing better seal. We hypothesized that this proposed newer mask ventilation technique would result in increased ventilation in terms of expired tidal volume.

This randomized crossover study designed to evaluate efficacy of newer mask ventilation technique against conventional thenar eminence mask ventilation technique.