Abstract
The laryngeal mask airway consists of a tubular oropharyngeal airway to the distal end of which is sealed a silicone laryngeal mask with an inflatable rim which provides an airtight seal around the larynx. It provided a clear airway in 238 of 250 elective and emergency nonobstetrical patients for a wide variety of surgical procedures, ranging from minor gynaecological and urological procedures to major abdominal and orthopaedic surgery with either spontaneous respiration or intermittent positive pressure ventilation. Anaesthetic techniques and drugs were similar to those which would have been used for the same procedures if face-mask or tracheal intubation had been employed. Blind insertion of the laryngeal mask airway was successful at the first attempt in 187 patients, some manipulation was required in 61 patients, and insertion was impossible in two patients, each of whom had a small mouth. In ten patients tracheal intubation was required because of airway obstruction or a large gas leak. The LM airway does not require laryngoscopy for its insertion, it relieves the anaesthetist’s hands from holding a face-mask, it cannot be misplaced in the oesophagus, and it is well tolerated during emergence from anaesthesia.
Résumé
Le masque laryngé est en fait une sorte de canule oropharyngee couplee à son bout distal à un masque de silicone au contour gonflable devant s’adapter étanchément à l’ouverture du larynx. Nous l’avons utilisé avec succés dans 238 des 250 interventions chirurgicales ou nous l’avons essayé, qu’elles soient urgentes ou électives, d’ordre gynécologique, urologique orthopédique ou même de type intraabdominal et ce, en ventilation spontanée ou contrôlée. Les anesthésiques utilisés l’étaient de la même façon que lorsque on utilisé un masque ordinaire ou un tube endotrachéal. L’insertion à l’aveugle du masque laryngé fut réussie du premier coup chez 187 patients et nécessita quelques manipulations chez 61 autres. Elle s’avéra impossible chez deux patients qui avaient une petite bouche et on dut procéder à l’intubation de dix autres à cause soit d’obstructions ou de fuites importantes. Contrairement au masque ordinaire, on n’a pas besoin de tenir le masque laryngé et son insertion se fait sans laryngoscope. De plus, il est impossible de le mettre dans l’œsophage et les patients tolerent facilement sa présence lors du réveil.
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Maltby, J.R., Loken, R.G. & Watson, N.C. The laryngeal mask airway: clinical appraisal in 250 patients. Can J Anaesth 37, 509–513 (1990). https://doi.org/10.1007/BF03006317
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DOI: https://doi.org/10.1007/BF03006317