SPecial Article The Laryngeal
Mask Airway
Angus 1. McEwan, MB ChB, FCAnaes,* David G. Mason, MB BS, FFARCS* Department
of Anesthesiology,
Duke
University
Medical
(;enter,
I)urh;t~r~, N(:.
The lavyngeul mask airwuy (LMA) ik a neus concept in nirway Introduction management. A miniature inflatable mask Cspositioned in the ‘The laryngeal mask airway (LMA) is a new concept in hypophavynx, forming a low-&+es.rure.seal around the lavyngeal airway management developed in Great Britain by Dr. inlet. The musk is attached Ga a tube to the breathing circuit. A.I.J. Brain.1 In clinical practice, it has the potential to It is inserted after ivtduction of anesthesia without the need fivvextend the anesthesiologist’s options by providing an almuscle relaxants or lavyngoscopy. Thp LMA ru,n be used to ternative to thr face mask and endotracheal tube. It pro,fucilitate both spontaneous and controlled zlevvtilutionin adults vides a clear airway while avoiding the need for trachea1 and children. intubation, with its potential morbidity.’ It has been used The LMA bas been usedfor a wide uariety qf surgical procedv1re.t to facilitate spontaneous and controlled ventilation in but is probnb~~ bnt .suited to .short proreduvzs, especial& ;J a adults and children. The LMA may have an important light general anesthetic is used in combination with a regional role in the management of the difficult airway. Its poptechnique. It may be particularly usef&l ivl outpatient anctthe.sia, ularity has quicklv spread since its introduction, and it as it avoids the need for intubation or murcle relaxav&s. il can is IIOW widely used by anesthesiologists in the United be used as an alterv&tive to mask anesthesia or when avl enKingdom.i Although not currently available in the United dotrachea, tube would have been inserted to allow .\urgiral arStates, it seems likely that the LM,4 wil1 be available in ress. It kas been used .successfully in rases of diffïcult ov-fûiled the near future. The purpose of this article is to provide intubution, ulthough its role here needs further ajv$vraisal. a review of the available literature. It does nat protect against usjviration oj .stomach uvvitevits and .should not be med when aspiratiorr is a risk. Covltrouer,s~exist.s regurding its use to,farilitate positiue-pre,s.surez,c~vltilatiovl(PPI:)PP~~) Concept and Development due to conrervl that gases under prcssure muy be forced into the .stomuch and predispose the patient IO re,~uvgitatiovl.It vnulbbe ITronr ar1 engineering standpoint, a gastight junction bevnore diffirult to use in children. tween two tubes (trachea and artiflcial airway) can be It is now wide
Mask Airway
Angus 1. McEwan, MB ChB, FCAnaes,* David G. Mason, MB BS, FFARCS* Department
of Anesthesiology,
Duke
University
Medical
(;enter,
I)urh;t~r~, N(:.
The lavyngeul mask airwuy (LMA) ik a neus concept in nirway Introduction management. A miniature inflatable mask Cspositioned in the ‘The laryngeal mask airway (LMA) is a new concept in hypophavynx, forming a low-&+es.rure.seal around the lavyngeal airway management developed in Great Britain by Dr. inlet. The musk is attached Ga a tube to the breathing circuit. A.I.J. Brain.1 In clinical practice, it has the potential to It is inserted after ivtduction of anesthesia without the need fivvextend the anesthesiologist’s options by providing an almuscle relaxants or lavyngoscopy. Thp LMA ru,n be used to ternative to thr face mask and endotracheal tube. It pro,fucilitate both spontaneous and controlled zlevvtilutionin adults vides a clear airway while avoiding the need for trachea1 and children. intubation, with its potential morbidity.’ It has been used The LMA bas been usedfor a wide uariety qf surgical procedv1re.t to facilitate spontaneous and controlled ventilation in but is probnb~~ bnt .suited to .short proreduvzs, especial& ;J a adults and children. The LMA may have an important light general anesthetic is used in combination with a regional role in the management of the difficult airway. Its poptechnique. It may be particularly usef&l ivl outpatient anctthe.sia, ularity has quicklv spread since its introduction, and it as it avoids the need for intubation or murcle relaxav&s. il can is IIOW widely used by anesthesiologists in the United be used as an alterv&tive to mask anesthesia or when avl enKingdom.i Although not currently available in the United dotrachea, tube would have been inserted to allow .\urgiral arStates, it seems likely that the LM,4 wil1 be available in ress. It kas been used .successfully in rases of diffïcult ov-fûiled the near future. The purpose of this article is to provide intubution, ulthough its role here needs further ajv$vraisal. a review of the available literature. It does nat protect against usjviration oj .stomach uvvitevits and .should not be med when aspiratiorr is a risk. Covltrouer,s~exist.s regurding its use to,farilitate positiue-pre,s.surez,c~vltilatiovl(PPI:)PP~~) Concept and Development due to conrervl that gases under prcssure muy be forced into the .stomuch and predispose the patient IO re,~uvgitatiovl.It vnulbbe ITronr ar1 engineering standpoint, a gastight junction bevnore diffirult to use in children. tween two tubes (trachea and artiflcial airway) can be It is now wide
