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Correspondence  |   July 2007
Preparation and Insertion Method of a Laryngeal Mask Airway: An Alternative Approach
Author Notes
  • Support was provided solely from institutional and/or departmental sources.
    Support was provided solely from institutional and/or departmental sources.×
    (Accepted for publication March 8, 2007.)
    (Accepted for publication March 8, 2007.)×
Article Information
Correspondence
Correspondence   |   July 2007
Preparation and Insertion Method of a Laryngeal Mask Airway: An Alternative Approach
Anesthesiology 7 2007, Vol.107, 182. doi:10.1097/01.anes.0000268279.47453.d9
Anesthesiology 7 2007, Vol.107, 182. doi:10.1097/01.anes.0000268279.47453.d9
To the Editor:—
Several techniques have been described for insertion of the various iterations of the laryngeal mask airway, including complete or partial evacuation of air from the cuff, the use of insertion devices, and a deflator device. Insertion difficulty can occur when the tip of the deflated cuff folds backward, causing drag and trauma to the posterior pharynx. This problem is due in part to the manner in which the cuff is deformed during its deflation before insertion of the laryngeal mask airway. An alternative technique is to control this deformation by manually guiding the cuff into an anterior (forward) position during cuff deflation. This cannot be accomplished by simple evacuation of the air from the cuff. The posterior surface of the oval cuff is then lubricated. After advancing the laryngeal mask airway into the mouth, extend the patient's neck and slide the laryngeal mask airway into position. Personal experience suggests this technique results in more rapid insertion, fewer traumatic insertions, and a higher rate of initial success. It also avoids placing a hand in the patient's mouth (fig. 1).
Fig. 1.
Laryngeal mask airway with manually guided deflation (top) and standard deflation (bottom).
Laryngeal mask airway with manually guided deflation (top) and standard deflation (bottom).
Fig. 1.
Laryngeal mask airway with manually guided deflation (top) and standard deflation (bottom).
×
Andrew B. Freeman, M.D. Medical City Dallas Hospital, Dallas, Texas. afreemanmd@mac.com
Fig. 1.
Laryngeal mask airway with manually guided deflation (top) and standard deflation (bottom).
Laryngeal mask airway with manually guided deflation (top) and standard deflation (bottom).
Fig. 1.
Laryngeal mask airway with manually guided deflation (top) and standard deflation (bottom).
×