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Article
The Laryngeal Mask Airway: technical guidelines and use in special situations

Author: Ahmed Abdulameer SALIH
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2006 Volume: 5 Issue: 2 Pages: 230-239
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

Summary:Recent advances in airway management have changed the practice of anesthesia. Among these changeshas been the introduction and increasing use of the Laryngeal Mask Airway (LMA). The laryngeal maskairway (LMA) is a novel device that fills the gap in airway management between tracheal intubation anduse of the face mask.This study describes the LMA, different methods of LMA insertion, uses, advantages, problems,complications and contraindications of LMA.During eight years of LMA use in Al-Yarmook teaching hospital in Baghdad, the device was used forwide spectrum of surgical procedures successfully. We report some special series of cases were LMAswere used in providing a patent airway include LMA use with IPPV (intermittent positive pressureventilation), for patient with history of failed intubation, for children who require general anesthesia forultrasonic shock wave lithotripsy, the use of reinforce flexible LMA for nasal surgery and the use of totalintravenous anaesthesia with LMA. Also we describe two methods of blind endotracheal intubationthrough LMA.


Article
The Use of Laryngeal Mask Airway during Anaesthesia for Surgery in the Prone Position in Spontaneously Breathing Patients

Authors: WAJEEH HAMDI AL-ALOUSI --- AHMED ABDULAMEER SALIH
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2006 Volume: 6 Issue: 1 Pages: 65-76
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: The prone position is required for many surgical procedures and maintaining and securing the airway in that position is a major concern for the anesthesiologists. The present study was conducted to evaluate the use of the Laryngeal mask airway (LMA) during anaesthesia in prone position in spontaneously breathing patients.Methods: We describe a prospective study of 40 patients, who ranked in ASA physical status class one and two and required general anaesthesia for surgery in prone position and LMA was used to maintain the airway. Different induction techniques were used and different methods of LMA insertion was used.Results: In 37 patients the LMA was inserted successfully from the first attempt, while in the other three patients there were malpositioned and reposition done successfully. Additional propofol was given to two patients who required deepening of anaesthesia after the LMA could be inserted. No laryngospasm or bleeding from the mouth was recorded. Only one patient vomited once 5 minutes after Extubation, after the protective reflexes had returned well. Conclusions: With experience, appropriate patient selection and good preparations, it is possible to induce and maintain anaesthesia using LMA in spontaneously breathing patients in the prone position.

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