Biomedical subjects
Publications and source records attributed to J A Pracilio.
A 46-year-old male with a known history of difficult intubation presented for elective surgery. It was considered prudent to perform an awake intubation and a size 3 laryngeal mask was introduced under topical anesthesia. A gum elastic bougie was then passed, enabling the laryngeal mask to be removed and a tracheal tube to be inserted.
Observations were recorded from two hundred consecutive insertions of the laryngeal mask airway (LMA). They were undertaken by 27 anaesthetists most of whom had no previous experience of its use. A clinically patent airway was obtained in 94% of patients and in the majority of these (76%) the LMA was positioned correctly at the first attempt. There were twelve cases of failed insertion. Nine of these were as a result of an inability to pass the LMA correctly into the hypopharynx while in the remaining three cases complete airway obstruction was reported. The insertion technique was easily acquired and trainee anaesthetists achieved a success rate of 84% for their first five attempts. Success with the LMA was related to experience: anaesthetists who had used the LMA over 15 times had no failures in 67 insertions. Twenty-two patients coughed and six developed mild laryngospasm at insertion. The incidence of postoperative sore throat was 8%.