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Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(1):6-9; doi:10.1093/bjaceaccp/mkn047
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© The Board of Management and Trustees of the British Journal of Anaesthesia [2009]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Laryngeal mask airway and other supraglottic airway devices in paediatric practice

Bhavesh Patel, FRCA
Specialist Registrar in Anaesthesia
Great Ormond Street Hospital for Sick Children
London WC1 N 3JH
UK

Robert Bingham, FRCA
Consultant in Anaesthesia
Great Ormond Street Hospital for Sick Children
London WC1 N 3JH
UK
Tel: +44 020 7829 8865 Fax: +44 020 7829 8866 E-mail: binghr@gosh.nhs.uk

The first 150 words of the full text of this article appear below.


Key points

Successful placement of any supraglottic airway device depends particularly upon pharyngeal tone, and also on the position of head and neck, shape of the palato-pharyngeal curve, and depth of anaesthesia.
LMA cuff volumes should be adjusted to the minimum needed to achieve airtight seal. The optimal size of LMA must be selected rather than overinflating a small LMA.
The LMA has been shown to be useful to bypass pathology at supraglottic level and facilitate emergency oxygenation and ventilation for the difficult airway.
Complications are more likely when using the LMA in infants and small children, particularly sizes 1 and 1.5.
A learning curve exists for the use of LMAs in paediatric practice; early complications are encountered more frequently than in adult practice.

 

Since its introduction into paediatric anaesthesia in the late 1980s, the laryngeal mask airway (LMA) has been used increasingly to provide hands-free airway management in paediatric . . . [Full Text of this Article]


   Paediatric LMA
 
Size selection

Cuff filling volumes and pressures

Oropharyngeal leak pressures

Positive pressure ventilation

LMA removal

Difficult airway management

Resuscitation

Training issues


   Reinforced LMA
 

   Proseal LMA
 

   Single-use laryngeal masks
 

   Laryngeal tube
 

   Cobra Perilaryngeal Airway
 

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