How effective is Face mask ventilation before and after neuromuscular blockade?

Recently published study examined the use of neuromuscular blocking drugs (NMBDs) to improve face mask ventilation in patients with normal airways undergoing elective surgery under general anesthesia. A total of 130 patients were included in the randomized controlled study and allocated into two groups. The primary objective was to measure expiratory tidal volumes at fixed time intervals during face mask ventilation with or without the administration of NMBD. The study found that early administration of NMBD significantly improved expiratory tidal volumes, with a significant difference observed after 90 seconds of administration. Additionally, the study reported that time to intubation was significantly less in the group that received NMBD early. However, there was no difference in the grade of mask ventilation between both groups. The study highlighted the potential benefits of NMBDs in improving face mask ventilation, but also acknowledged limitations, such as the exclusion of patients with difficult airways. Overall, the study concluded that administering NMBDs improved face mask ventilation as measured by expiratory tidal volumes. The findings were in line with previous studies that also reported improvements in mask ventilation with early administration of NMBDs, but the exact mechanism for these improvements remains unknown. The study recommended further research in this area and emphasized the importance of rescue intervention with adequate neuromuscular blockade in scenarios of difficult mask ventilation and intubation.

Reference –

Kumar, Supriya; Hussain, Mumtaz; Bharti, Alok K.; Kumar, Arvind. Efficiency of face mask ventilation before and after neuromuscular blockade: A randomised, double-blind controlled study. Indian Journal of Anaesthesia 67(12):p 1096-1100, December 2023. | DOI: 10.4103/ija.ija_494_23