A Case of Acromegalic Patient with Usefulness of Nasal Ventilation during Anesthetic Induction

Abstract

  The incidence of difficult mask ventilation and intubation is higher in patients with acromegaly than in normal patients. In the present case with acromegaly, nasal-mask ventilation, but not combined oral-nasal mask ventilation, was able to provide effective ventilation during anesthetic induction. The reason was that positive pressure during nasal mask ventilation was generated only in the nasopharynx, and the pressure gradient between the nasopharyngeal and oropharyngeal cavities was able to overcome the effect of gravity on the soft tissues like the tongue enlargement, and then provide patent airway.
  During anesthetic induction of general anesthesia in an acromegaly patient, nasal mask ventilation is more effective than combined oral-nasal mask ventilation.