Correspondence  |   November 2017
“Loose Lips Are Actually Good”
Author Notes
  • University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (C.W.B.). buffingtoncw@gmail.com
  • (Accepted for publication July 5, 2017.)
    (Accepted for publication July 5, 2017.)×
Article Information
Correspondence
Correspondence   |   November 2017
“Loose Lips Are Actually Good”
Anesthesiology 11 2017, Vol.127, 897. doi:10.1097/ALN.0000000000001828
Anesthesiology 11 2017, Vol.127, 897. doi:10.1097/ALN.0000000000001828
We compliment Sato et al.1 on their recent article concerning mask ventilation during the induction of general anesthesia. A prominent feature of this study is the occurrence of expiratory flow limitation during positive pressure ventilation in 29% of subjects. This phenomenon is not widely appreciated as a cause of difficult mask ventilation. Sato et al.’s results confirm and extend observations that our group has previously reported.2  Our audit strongly supports a “floppy” soft palate as the site of expiratory obstruction and demonstrates that opening the mouth during exhalation improves ventilation by allowing gas to exit the lungs.
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