Objective: The most common reason for failure to ventilate with the one-handed CE technique is air leak in patients with difficult mask ventilation. Sub-mandibular one-handed grip is the alternative technique that minimizes air leak. The aim of the study was to compare exhaled volume in sub-mandibular one-handed grip technique to CE technique.

Materials and Methods: Thirty patients who potential air leak during mask ventilation undergoing elective surgery were randomly divided into two groups. Patients in Group 1 were given mask ventilation with CE technique before switching to sub-mandibular one-handed grip technique and patients in Group 2 were given mask ventilation with sub-mandibular one-handed grip technique before switching to CE technique. Exhaled tidal volume, peak airway pressure, heart rate, pulse oximetry were recorded.

Results: Sub-mandibular one-handed grip technique showed lower air leak than the CE technique statistically significant (2.9+1.9 ml/kg vs. 3.9+2.5 ml/kg, p = 0.01). Neither patient had experienced oxygen desaturation nor had a change in heart rate in the present study.

Conclusion: The sub-mandibular one-handed grip technique is more effective in reducing air leaks than one-handed CE technique for patients with potential difficult mask ventilation.

Keywords: Difficult mask ventilation, Air leaks during ventilation, Sub-mandibular one-handed grip technique, CE technique