Laryngeal Mask Airway

Question 1

What is the place of the LMA in airway management

Answer 1

Fills place between maintaining the airway with a facemask and an endotracheal tube

Replaced need for bag, valve and mask technige in maintenanceof anaesthesia

Alllowed for low flow anasesthesia

No need for muscle relaxants to be given to every patient

up to 2/3rs GA involve use of LMS

Question 2

Indications for LMA use

Answer 2

1. Spontaneously breathing patients as an alternative to face mask for shorter surgical procedures
2. Emergency management of difficult airway/failed intubation
3. Used in ventilated patients up to a peak airway pressure of less than 20 cm H2)

Question 3

Contraindications for LMA use

Answer 3

1. Patients at risk of regurgitation

• full stomach
• mobid obsesity
• pregnancy
• hiatus hernia

** 2. Poor lung compliance & high airway pressure eg COPD**

Question 4

LMA Pre-use checks

Answer 4

1. Visual inspection:- blockages and kinkages, are aperture bars intact
2. Inflate cuff to maximum recommended plus 50percent (check for leakage, symmetry and herniation
3. Difflate cuff
4. Apply water soluble lubricant to back surface of cuff only.

Question 5

Advantages of LMA

Answer 5

• Can be used by inexperienced personel
• Improved haemodynamic stability at induction and during emergence
• Minimal increase in intraoccular pressure following insertion
• Lower freqency of coughing during emergence
• Improved O2 sats during emergence
• Lower incidence of sore throats in adults

Question 6

Disadvantages of LMA

Answer 6

• lower seal pressure than ETT
• increased risk of gastric insufflation
• risk of aspiration