Anest. intenziv. Med. 2018;29(2):67-71

Is laryngeal mask airway the method of choice for airway management in open tracheal surgery?Celková anestezie - kazuistiky

M. Krečmerová¹, V. Bicek¹, J. Schützner², K. Adámková¹, P. Michálek³, T. Vymazal^1,*

¹ Klinika anesteziologie, resuscitace a intenzivní medicíny, 2. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice v Motole

² III. chirurgická klinika, 1. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice v Motole

³ Klinika anesteziologie, resuscitace a intenzivní medicíny, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice v Praze

Introduction:
Any resection and reconstruction of the trachea in stenotic lesions is a complex procedure with potentially challenging airway management. The aim of this case series is to assess the suitability and safety of the laryngeal mask airway in these procedures.

Materials and methods:
The charts of 54 consecutive patients operated on at University Hospital Motol during 2009-2016 period were reviewed. The surgery was done in the same ENT department and the anaesthetics were given by one of two anaesthetists with more than 15 years of experience. We evaluated the tracheal stenosis parameters, ease of insertion of the laryngeal masks, incidence of failure, quality of the fibreoptic view through the device, perioperative ventilation, pulmonary aspiration rate, incidence of 24-hour postoperative bleeding, 48-hour suture dehiscence rate and 30-day mortality following surgery.

Results:
In our 54-patient series the laryngeal mask provided patent airway throughout the procedure in 52/54 (96.4%) of them. Insertion of the device failed in one patient (1.8%) due to abnormal upper airway anatomy. Another patient (1.8%) developed laryngeal mask malposition due to neck extension during the procedure and required tracheal intubation. Fibreoptic view through the devices including insertion of the flexible bronchoscope was satisfactory in 52 patients (96.4%). We did not record any case of pulmonary aspiration, early postoperative bleeding, suture dehiscence or 30-day mortality.

Conclusion:
Based on this analysis of 54 patients we would consider laryngeal mask airway a safe method of choice during tracheal stenosis surgery.

Keywords: resection of tracheal stenosis; laryngeal mask; general anaesthesia; TIVA

Received: January 11, 2018; Accepted: March 28, 2018; Published: April 1, 2018  Show citation