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Improved face mask ventilation in the bearded patient

Gourdin, M. J.1; Dransart, C. J.1; Ducombs, O.1; Dubois, P. E.1

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European Journal of Anaesthesiology: November 2005 - Volume 22 - Issue 11 - p 894
doi: 10.1017/S0265021505251505


Maintenance of airway patency and oxygenation are the main objectives of face mask ventilation. However, certain clinical and anatomical situations can make these difficult [1]. In particular, the presence of a beard impairs the seal between the face mask and the face, often making positive pressure ventilation ineffective even with high fresh gas flow and increased applied pressure on the patient's face. Langeron and colleagues recommended the shaving of the beard before general anaesthesia [2]. This is unacceptable to most patients. We add a 5 mm layer of echography contact gel (Aquasonic 100; Parker Laboratories Inc., Fairfield, NJ) onto the edge of the mask and this improves the effectiveness of the ventilation in the presence of a beard. The viscous gel impregnates the hairs of the beard creating a semi-liquid joint that gives a better seal permitting the ventilation of the patient in security and comfort with neither air leakage nor excessive pressure on his face. This method is simple, fast, cheap and compatible with most face masks. The gel is water-soluble, has a neutral pH and is easily removed with a damp cloth. We do not know of any complication with the contact gel. We nevertheless take extra care to cover the eyes with a suitable material before the application of the gel and positive pressure ventilation.

M. J. Gourdin

C. J. Dransart

O. Ducombs

P. E. Dubois

1Department of Anaesthesiology, University Hospital of Mont-Godinne, University of Louvain, Yvoir, Belgium


1. Finucane BT, Santora AH. The difficult airway. In: Finucane BT, Santora AH, eds. Principles of Airway Management. New York, USA: Spinger-Verlag, 2003: 216-254.
2. Langeron O, Masso E, Huraux C, et al. Prediction of difficult mask ventilation. Anesthesiology 2000; 92: 1229-1236.
© 2005 European Society of Anaesthesiology