British Journal of Anaesthesia, 2001, Vol. 86, No. 6 749-753
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia
Editorial |
Editorial III
Is it safe to artificially ventilate a paralysed patient through the laryngeal mask? The jury is still out
LMA® is the property of Intavent Limited.
The laryngeal mask airway (LMA) was developed and introduced by Brain in 1983 with the intention of finding a compromise between a facemask and a tracheal tube.1 Since then it has undergone various modifications including: the flexible tube has been reinforced; a bigger size has been introduced (no. 5); a change in shape has been made for the intubating laryngeal mask (ILMA);2 and a different material has been used (silicon or polyvinyl chloride) for the disposable LMA.3 The LMA is now used by some practitioners during percutaneous dilatational tracheostomy in the intensive care unit;4 it has a firm place in the management of patients who are difficult to intubate;5 and, by decreasing the incidence of dysphonia6 and sore throat,7 8 it is contributing to patient comfort, especially after day case surgery. In future, pharyngeal oximetry with the LMA may be a more accurate means of monitoring the SaO2 of
Advantages of the LMA
Disadvantages
Gastric insufflation
Regurgitation into oesophagus
Aspiration of gastric contents
Critical incidents from LMA usage
A concluding paradox
References
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