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British Journal of Anaesthesia, Vol 81, Issue 5 787-789, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia

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Vital capacity and tidal volume preoxygenation with a mouthpiece

S. Winship and A. Skinner
University Department of Anaesthesia, Royal Liverpool and Broad Green University Hospital, Liverpool L7 8XP; Department of Anaesthesia, Whiston Hospital, Merseyside L35 5DR

We have measured oxygen wash-in in 20 volunteers undergoing preoxygenation with a face mask, mouthpiece alone and a mouthpiece with a noseclip, in a crossover study. Tidal volume breathing and maximal deep breath techniques were studied with each type of equipment. When tidal volume breathing was used, the face mask and mouthpiece with noseclip were comparable, but the mouthpiece alone achieved a lower end- expiratory oxygen concentration than the two other methods after 3 min (P < 0.001 and P < 0.01), and after 5 min (P < 0.05 in each case). Conversely, during preoxygenation with vital capacity breaths, the mouthpiece and mouthpiece with noseclip were comparable, and both were more effective than the face mask (P < 0.001). In a second study, 20 patients who had undergone preoxygenation before induction of anaesthesia were asked later if they would have preferred the face mask or mouthpiece for this procedure. Significantly more patients (14 of 18 who expressed a preference) favoured the mouthpiece (P < 0.05; confidence limits 0.56-0.92).
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