Abstract

ANESTHESIA AND LARYNGEAL MASK AIRWAY (LMA)

Dr. Waleed Hammadi Idan*

ABSTRACT

The laryngeal mask airway (LMA) is a supraglottic airway device developed by British Anesthesiologist Dr. Archi Brain. It has been in use since 1988. Initially designed for use in the operating room as a method of elective ventilation, it is a good alternative to bag-valve-mask ventilation, freeing the hands of the provider with the benefit of less gastric distention.[1] Initially used primarily in the operating room setting, the LMA has more recently come into use in the emergency setting as an important accessory device for management of the difficult airway. The LMA is shaped like a large endotracheal tube on the proximal end that connects to an elliptical mask on the distal end. It is designed to sit in the patient’s hypopharynx and cover the supraglottic structures, thereby allowing relative isolation of the trachea. The patient should be obtunded and unresponsive before one of these devices is placed. The LMA is a good airway device in many settings, including the operating room, the emergency department, and out-of-hospital care, because it is easy to use and quick to place, even for the inexperienced provider. A success rate for placement of a LMA of nearly 100% occurs in the operating room. A lower rate of achievement for LMA placement may be expected in the emergency setting. Its use results in less gastric distention than with bag-valve-mask ventilation, which reduces but does not eliminate the risk of aspiration. This may be particularly pertinent in patients who have not fasted before being ventilated.

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