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2002, Number 1

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Rev Mex Anest 2002; 25 (1)

Anestesia general. Empleo de la mascarilla larínea (LMA) en cirugía convencional..

Álvarez RJJ, Vaneas HM, Cano JGZ, López AM, Prado T, Zúñiga SG

Language: Spanish
References: 27
Page: 19-23
PDF size: 66.47 Kb.


ABSTRACT

Background: The use of the Laringe Mask in present anesthetic practice has gradually taken a priority position in the protocols of some groups. In it we have found a highly valuable resource for conventional surgery, such as situations which are high-emergency because of endotracheal intubation difficulty. Material and methods: In the present study, the results of the first 300 cases of airway management in conventional surgical anesthesia are reported. These were carried out in random fashion and without additional information. The objectives of the study were centered on evaluation of the safety, ease of application, possibility of airway management with positive pressure ventilation, length of the procedures, hemodynamic stability and respiratory function, anesthetic depth required, its removal and undesirable collateral effects at the end of the procedure. Results: The results are reported by patients with a median age of 33.2 years with a median weight of 71 kg. with a duration of 60.5 minutes in a minimum of 10 min. and a maximum of 180. Simple LMA application was achieved in 254 patients, on a second attempt in 36 cases, on a third attempt in 8, and abandoning the procedure in the other 2, where Endotracheal Intubation was resorted to. In 43 % of cases controlled mechanical ventilation was used, controlled manual in 9.6 % and assisted spontaneous ventilation in 47.4 %. The oximeter showed levels above 96 %. The procedure was free of important hemodynamic changes. Upon finishing the procedure, we found 12 patients who reported oropharingeal pain and in 30 % of cases the LMA was bloodstained. Upon removal of the mask we found 10 patients who mentioned nausea without vomiting. Discusion: The present study demonstrates that the Laringe Mask ia an accesory which delivers a safe and effective procedure with spontaneous ventilation as well as with controlled ventilation, with considerable approval from both the surgical team and the patients themselves.


REFERENCES

  1. Brain AIJ. The laringeal mask - A new concept in airway management. Br J. Anaesth 1983; 55: 801-805.

  2. Mancha E, Torres J, Mackelligan P, Leos A, Salazar MR. Mascarilla laríngea en cirugía plastica ambulatoria, experiencia clinica en 100 casos. Anestesia en México 1994;5:287-290.

  3. Acosta VM, Ramirez A J. Inovaciones en el manejo no invasivo de la via aerea Anestesia en México 1994; 6: 353-354.

  4. Hath ML, Allagain J. The brain laringeal mask airway as an aid to intubation. Br. J. Anaesth; 1990; 64: 382-383.

  5. Maltby JR, Loken RG,Watson NC. The Laryngeal mask airway: Clinical appraisal in 250 patients. Can J Anaesth 1990; 37:5 509-13.

  6. Brain Aij. Laryngeal mask airway (letter). Anesthesiology 1992;76:1061.

  7. Verghese CH, Brimacombe JR. Survey of laringeal mask airway usage in 11,910 patients. Safety and efficacy for conventional and nonconventional usage. Anesth Analg 1996;82:129-133.

  8. Benumof JL. Management of the difficult adult airway. Anesthesiology 1991;75:1087-1110.

  9. Benumof JL. Management of the difficult Airwaay: ASA Algorithm 1993 Annual refresher Course Lectures, 531, 1993.

  10. McCrory C, Moriarty D. Laryngeal Mask Airway Positioning is related to Mallampati Grading in Adults. Anesth. Analg. 1995;81:1001-4.

  11. McCrory C, Moriarty D. Laryngeal Mask Airway Positioning is related to Mallampati Grading in Adults. Anesth. Analg. 1995;81:1001-4.

  12. Haden RM, Pinnock CA, Scott PV. Incidence of aspiration with the laryngeal mask airway. Br J Anaesth 1994;72:496.

  13. Rabey PG, Murphy PJ, Langton JA, Barker P, Rowbotham DJ. Effect of the Laryngeal Mask Airway on lower oesophageal sphincter pressure in patients during general Anaesthesia. British Journal of Anaesthesia 1992;69:346-348.

  14. Owens TM, Robertson P, Twomey C, et al. The incidence of gastroesophageal reflux with the laryngeal mask. Anesth Analg 1995;80:980-4.

  15. Gursoy F,Algren JT, Skjonsby B. Positive Pressure Ventilation with the Laryngeal Mask Airway in children Anesth. Analg 1996;82:33-8.

  16. Weiler N, Latorre F, Eberle B, Goedecke R, Heinrich W. Respiratory Mechanics, Gastric Insufflation Pressure, and Air Leakage of the Laryngeal Mask Airway. Anesth. Analg 1997;84:1025-8.

  17. Sarma VJ. The use of laryngeal mask airway in spontaneously breathing patients. Acta Anaesthesiol Scand 1990;34:669-672.

  18. Wakeling Howard, Butler PJ. Baxter P. The Laryngeal Mask Airway: A comparison Between Two insertion Techniques. Anesth. Analg 1997;85:687-90.

  19. Bapat P, Joshi RN, Young E, Jago RH. Laryngeal mask insertion. Comparison of Propofol and Thiopental. World Congress af Anaesthesiologists. Sydney, Australia 1996, Abstract book D565, pag 170.

  20. Brimacombe J, Berry A. The incidence of aspiration associated with the laryngeal mask airway- a meta-analysis of published literature. J Clin Anesth 1995;7:297-305.

  21. Green D, Ward B, Hughes N. Abscense of pressor response following early insertion of laringeal mask airway after induction with Propofol-fentanil Br J. Anaesth 1994;72: A54.

  22. Fujii Y, Tanaka H, Tokooka H. Circulatory responses to laryngeal mask airway insertion or tracheal intubation in normotensive and hypertensive patients. Can J Anaesth 1995, 45:32-36.

  23. Keller C, Brimacombe J, Agro F, Margreiter J. A pilot Study of Pharyngeal Pulse Oximetry with the Laryngeal Mask Airway. Anesth Analg 2000;90:440-4.

  24. Longan A. Use of laryngeal mask in a patients with unstable fracture of the cervical spine (letter) Anaesthesia; 1991; 46:987.

  25. Kihara S, Watanbe S, Brimacombe J, Taguchi N, Yamasaki Y. Segmental cervical spine movement with the intubating Laryngeal mask during manual In-Line Stabilization in Patients with cervical pathology Undergoing Cervical Spine Surgery. Anesth. Analg. 2000;91:195-200.

  26. Patterson SJ, Byrne PJ, Molesky MG et al. Neonatal resucitation using the laryngeal mask airway. Anesthesiology ; 80 : 1248-1253,1994.

  27. Gandini Donna, Brimacombe J. Neonatal resucitation with the Laryngeal Mask Airway in normal and Low Birth Weight Infants. Anesth. Analg 1999;89:642-3.




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