Case 21: A Possible Solution to a Difficult Laryngeal Mask Airway Placement
- 74 Downloads
A 40-year-old ASA 1 female with a Mallampati class 2 airway is scheduled for cystoscopy and biopsy of the bladder under general anesthesia. She weighs 80 kg and is 165 cm in height. Her only complaint is hematuria. This is her first hospital admission and first general anesthetic. She refuses a spinal or epidural. You induce general anesthesia with propofol 150 mg. The placement of soft reusable laryngeal mask airway (LMA) with the Brain technique proves impossible as the LMA will not pass the junction with the posterior pharynx. You attempt to insert the LMA with other different techniques, including rotating the LMA 180 degrees, to no avail. Unfortunately, no other LMA’s are available.
KeywordsLMA Mallampati General Anesthesia Brain Technique Stylet Yodfat Technique Endotracheal Tube Stylet
- 3.Brimacombe J, Berry A. Insertion of the laryngeal mask airway – a prospective study of four techniques. Anesth Intensive Care. 1992;21:89–92.Google Scholar
- 4.Brain AIJ. The Intavent Laryngeal Mask Instruction Manual. 2nd ed. Brian Medical Ltd: Berkshire. UK; 1991.Google Scholar
- 5.Chu LF, Mathur PN, Trudell JR, Brock-Utne JG. Contamination problems with reuse of laryngeal mask airways and laryngoscopes. Saudi J of Anesthesia. 2008;2:58–61.Google Scholar