Advantages of mask anaesthesia

The advantage of mask anaesthesia is the very low degree of invasiveness (tissue damage). The mask is only held on the face and the Guedel tube, which is inserted to keep the airway open, is placed in the mouth area. There is no danger of damaging structures in the throat, vocal cords or the windpipe, as is the case with classical ventilation.

In addition, teeth, lips and tongue do not suffer any damage from ventilation with the mask. In addition, the muscle relaxant can be dispensed with in the case of mask anaesthesia. In regular anaesthesia this drug is very important for the insertion of the breathing tube.

Disadvantages of mask anaesthesia

Mask anaesthesia is only suitable for short procedures, as the anaesthetist or a specially trained anaesthetist must hold the mask in place at all times. Holding the mask therefore restricts the staff’s freedom of movement and action and means that two specialists are needed to maintain such an anaesthesia. Holding the mask can also be very strenuous, as it is important to ensure that no air escapes at the edges of the mask and that air from the ventilator reaches the lungs.

During mask anaesthesia, the esophagus and trachea are not separated by a breathing tube. This means that ascending gastric juice can enter the trachea. Therefore, only patients with a mask anaesthesia can be operated on, who are fasting safely.

Furthermore, only operations with mask anaesthesia are possible, in which the patient can lie on his back. Positioning on one side of the body or on the abdomen cannot be performed with the mask and is a contraindication for mask anaesthesia. The following topic could also be of interest to you: Anaesthetic drainage – procedure, duration and risks

Risks of mask anaesthesia

Although the airways can be kept relatively free with special handles and a Guedel tube, the ventilation situation is never as good as with the breathing tube, which is placed directly in the trachea. If good ventilation with the mask is not possible, the anesthesiologist will always decide to intubate afterwards, i.e. to insert a laryngeal mask. The second major risk is the lack of a protective barrier between the windpipe and the esophagus.

This barrier is normally formed by the breathing tube.In the case of mask anaesthesia, gastric juice may rise and flow through the windpipe into the lungs. If it is only gastric juice, this is unfavorable, but not harmful per se, since the gastric juice can be broken down in the lungs. However, if the gastric juice still contains oesophageal residues and these then enter the lungs, this can lead to pneumonia. For this reason, only completely empty patients should be given a mask anaesthetic.