Abstract
Purpose
To describe a case of vomiting with a laryngeal mask airway ProSeal™ (PLMA)in situ. The new design features of the PLMA and their role in protection from aspiration are discussed.
Clinical features
A 27-yr-old female underwent bilateral reduction mammoplasty under general anesthesia utilizing a PLMA for airway management. During transfer to the postanesthesia care unit, she had an episode of active vomiting with the PLMA stillin situ. The vomitus was expelled via the drain tube bypassing the pharynx entirely. Clinically, there was no evidence of aspiration and the patient had an uneventful recovery.
Conclusion
This case provides evidence that the drain tube of the PLMA directs vomitus away from the airway when properly positioned and may have prevented aspiration in an anesthetized patient.
Résumé
Objectif
Décrire un cas de vomissements en présence du masque laryngé ProSeal™ (MLP) in situ. Les nouvelles particularités du MLP et leur rôle dans la protection contre l’aspiration sont discutés.
Éléments cliniques
Une femme de 27 ans a subi une mammoplastie de réduction bilatérale sous anesthésie générale avec emploi d’un MLP pour l’ouverture des voies aériennes. Pendant le transfert à la salle de réveil, elle a eu des vomissements et le MLP était toujours en place. Les vomissement ont été évacués grâce à l’orifice de drainage protégeant le pharynx. Il n’y a pas eu de signe évident d’aspiration et la patiente a connu une récupération sans incident.
Conclusion
Ce cas apporte la preuve que le drain du MLP a permis de retirer les vomissements des vois aériennes quand il est bien mis en place. Il peut empêcher l’aspiration chez un patient anesthésié.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Nanji GM, Maltby JR. Vomiting and aspiration pneumonitis with the laryngeal mask airway. Can J Anaesth 1992; 39: 69–70.
Griffen RM, Hatcher IS. Aspiration pneumonia and the laryngeal mask airway. Anesthesia 1990; 45: 1039–40.
Koehli N. Aspiration and the laryngeal mask airway (Letter). Anaesthesia 1991; 46: 419.
Maroof M, Khan RM, Siddique MS. Intraoperative aspiration pneumonitis and the laryngeal mask airway (Letter). Anesth Analg 1993; 77: 409–10.
Cyna AM, MacLeod DM. The laryngeal mask: cautionary tales (Letter). Anaesthesia 1990; 45: 167.
Brain AIJ, Verghese C, Strube PJ. The LMA “ProSeal”— a laryngeal mask with an oesophageal vent. Br J Anaesth 2000; 84: 650–4.
Keller C, Brimacombe J, Kleinsasser A, Loeckinger A. Does the ProSeal laryngeal mask airway prevent aspiration of regurgitated fluid? Anesth Analg 2000; 91: 1017–20.
Warner MA, Warner ME, Weber JG. Clinical significance of pulmonary aspiration during the perioperative period. Anesthesiology 1993; 78: 56–62.
Brimacombe JR, Berry A. The incidence of aspiration associated with the laryngeal mask airway: a metaanalysis of published literature. J Clin Anesth 1995; 7: 297–305.
Barker P, Langton JA, Murphy PJ, Rowbotham DJ. Regurgitation of gastric contents during general anaesthesia using the laryngeal mask airway. Br J Anaesth 1992; 69: 314–5.
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 anesthesia. Br J Anaesth 1992; 69: 346–8.
Ho BYM, Skinner HJ, Mahajan RP. Gastrooesophageal reflux during day case gynaecological laparoscopy under positive pressure ventilation: laryngeal mask vs. tracheal intubation. Anaesthesia 1998; 53: 921–4.
Brain AI. The laryngeal mask and the eosophagus (Letter). Anaesthesia 1991; 46: 701–2.
Agro F, Brain A, Gabbrielli A, et al. Prevention of tracheal aspiration in a patient with a high risk of regurgitation using a new double-lumen gastric laryngeal mask airway. Gastrointest Endosc 1997; 46: 257–8.
Brimacombe J. Airway protection with the new laryngeal mask prototype. Anaesthesia 1996; 51: 602–3.
Evans NR, Llewellyn RL, Gardner SV, James MFM. Aspiration prevented by the ProSeal™ laryngeal mask airway: a case report. Can J Anesth 2002 49: 413–6.
Bernhard WN, Cottrell JE, Sivakumaran C, Patel K, Yost L, Turndorf H. Adjustment of intracuff pressure to prevent aspiration. Anesthesiology 1979; 50: 363–6.
Petring OU, Adelhoj B, Jensen BN, Pedersen NO, Lomholt N. Prevention of silent aspiration due to leaks around cuffs of endotracheal tubes. Anesth Analg 1986; 65: 777–80.
Priano LL. Trauma and burns.In: Barash PG, Cullen BF, Stoelting RK (Eds.). Clinical Anesthesia, 2nd ed. Philadelphia: J.B. Lippincott Co.; 1992: 1417–29.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mark, D.A. Protection from aspiration with the LMA-ProSeal™ after vomiting: a case report. Can J Anesth 50, 78–80 (2003). https://doi.org/10.1007/BF03020192
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03020192