All of the following are advantages of LMA except-
Correct Answer: Prevent aspiration
Description: Ans. is 'b' i.e., Prevent aspiration o LMA is intermediate between the face mask and Endotracheal intubation in terms of reliability, invasiveness and facilitation of gas exchance (face mask has minimum and endotracheal intubation has maximum)o LMA does not prevent aspiration - should not be used in full stomach patients.o LMA can be used as an alternative to endotracheal intubation for minor surgeries, where anaesthetist wants to avoid intubation.o LMA is introduced blindly (without laryngoscopy)Laryngeal Mask Airwayo The LMA is a supraglottic airway. It is also referred as Brain mask as it was invented by Dr. Archies Brain. LMA provides an airway intermediate between the face mask and tracheal tube in terms of anatomic position (face mask is on the face, LMA is in the larynx around inlet and tracheal tube is in the trachea), invasiveness, security to protect airway, and facilitate gas exchange. The principle of LMA is that it provides an effective gas tight seal around the laryngeal inlet without anything having to pass through vocal cord.o LMA is very effective in maintaining a patent airway in spontaneously breathing patient. Positive pressure ventilation may be applied if necessory without tracheal intubation.o LMA is available in 8 different sizes (Lee 13th/e 206).Mask sizePatient weight & ageMaximum inflation volume1< 5 Kg, neonates & infants4 ml1[?]55 - 10 kg, Infants7 ml210 -20 kg, Infants & children10ml2.520 - 30 kg, Children14330 - 50, Children & Small adults14450 - 70 kg, Adults30570-100 kg Adult406> 100 kg, Adult o After induction of anaesthesia with propofal (which depresses laryngeal reflexes) LMA is introduced blindly (without laryngoscopy) into the hypopharynx. One of the major disadvantage of LMA is that its seal around laryngeal inlet does not always prevent aspiration. Therefore, LMA should not be used where there is an increased risk of aspiration of stomach contents, e.g., full stomach patient.Indications of LMA1. As an alternative to intubation where difficult intubation is anticipated (difficult airway).2. To facilitate endo-tracheal intubation in a patient with difficult airways.3. Situations involving a difficult mask fit.4. Securing airway (as cardiopulmonary resuscitation) in emergency where intubation and mask ventilation is not possible.5. For minor surgeries (short surgeries), where anaesthetist wants to avoid intubation.6. As a conduit for bronchoscopes, small size tubes, gum elastic bougies.7. For extra and intra-ocular surgeries including retinopathy surgery in premature infants - LMA is particularly useful in ophthalmic surgery as problems created by other two airways are eliminated:-i) Face mask creates problem in surgical field access due to its size (LMA provides a better access).ii) Endotracheal intubation may cause raised IOT (LMA has no effect).
Category:
Anaesthesia
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