ISSN:
1460-9592
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Background : The objective of the present study was to evaluate the prelaryngeal position of the laryngeal mask airway (LMATM) in children, and to determine the influence of mask positioning on gastric insufflation and oropharyngeal air leakage.Methods : A total of 100 children, 3–11 years old, scheduled for surgical procedures in the supine position under general anaesthesia were studied. After clinically satisfactory LMA placement, tidal volumes were increased stepwise until air entered the stomach, airway pressure exceeded 30 cmH2O, or air leakage from the mask seal prevented further increases in tidal volume. LMA position in relation to the laryngeal entrance was verified using a flexible bronchoscope.Results : The insertion of the LMA with a clinically satisfactory position was achieved in all patients at the first attempt. Gastric air insufflation occurred in five of 49 patients with malpositioned LMA. No incident of gastric air insufflation was observed in 51 patients with correctly positioned LMA. The minimum inspiratory pressure leading to mask leakage was 17 cmH2O for incorrectly positioned LMA, and 25 cmH2O for correctly positioned LMA. Clinically unrecognized LMA malposition was associated with a significantly increased incidence of either oropharyngeal leakage (r = 0.59; P = 0.0001) or gastric insufflation (r = 0.25; P = 0.01).Conclusions : Clinically undetected LMA malpositioning is a significant risk factor for gastric air insufflation in children between 3 and 11 years, undergoing positive pressure ventilation, especially at inspiratory airway pressures above 17 cmH2O.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1046/j.1460-9592.2003.01213.x
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