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AMBULATORY ANESTHESIOLOGY

The Effect of Leaving Dentures in Place on Bag-Mask Ventilation at Induction of General Anesthesia

Niamh P. Conlon, FCARCSI^*, Richard P. Sullivan, MBChB^*, Peter G. Herbison, MSc^*, Mathew Zacharias, PhD^*, and Donal J. Buggy, MD

From the *Department of Anesthesia, Dunedin Hospital, Dunedin, New Zealand; Department of Anesthesia, Mater Misericordiae University Hospital, Dublin, Ireland; and Outcomes Research Institute, Cleveland Clinic, Cleveland, Ohio.

Address correspondence and reprint requests to Niamh Conlon, FCARCSI, Department of Anesthesia, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland. Address e-mail to tallniamh{at}hotmail.com.

Abstract

BACKGROUND: The optimum timing for denture removal in edentulous patients before anesthesia and surgery is uncertain.

METHODS: We conducted a prospective, randomized, controlled trial to evaluate the effect of leaving dentures in during bag-mask ventilation at induction of general anesthesia. One hundred sixty-six edentulous patients were randomized to two groups. The Dentures-In group was bag-mask ventilated after induction of anesthesia with dentures left in place. The Dentures-Out group patients had their dentures removed before bag-mask ventilation. The degree of difficulty of bag-mask ventilation was assessed by the anesthesiologist.

RESULTS: Successful bag-mask ventilation, as defined by a increase in ETco₂ to 20 mm Hg and back to baseline with 3 L/min fresh gas flow and the adjustable pressure limiting valve at 20 cm H₂O, was achieved in 61 of 84 (73%) of the Dentures-In patients compared with 40 of 81 (49%) of the Dentures-Out patients (odds ratio 0.37, 95% CI = 0.19–0.70, P = 0.002).

CONCLUSION: We conclude that bag-mask ventilation is easier in edentulate patients when their dentures are left in situ during induction of general anesthesia.

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