No abstract

The Laryngeal Mask Airway (LMA) has been used extensively to provide a safe airway in spontaneously breathing patients who are not at risk from aspiration of gastric contents. The increased risk of aspiration in Obstetric population was initially considered as a relative contra indication for LMA usage. But LMA proved to be safe in this subgroup and in fact significantly decreased tidal volume was noted during IPPV with a decreased the risk of aspiration. METHOD: This is a prospective study, performed in Niloufer Hospital for Children & Women from June 2011-January 2014 over a period of 30months. We studied the ease of insertion of single use ILMA and associated complications in 35 ASA 1 obstetric patients. RESULTS: The mean age of the patients was 27.4 years. The mean BMI was 28.4 kg /m 2. 21 patients were admitted for cerclage (60.0%), 5 Bartholin's abscess (14.28%), 6 cases of manual removal of placenta (17.14%), 3 cases of vescicular mole for evacuation (8.57%). The duration of anesthesia ranged from 20-40 min with a mean duration of 19 minutes. The first time insertion rate was 88.57%, 31 out of 35 patients had the LMA inserted in first attempt. 4 patients needed reinsertion. None of the patients had aspiration or other complications associated with LMA. There were no failed insertions. CONCLUSION: We conclude that the LMA is effective and safe for in carefully selected ASA 1 pregnant patients in the hands of experienced Anesthesiologist.

Lymphangiomas are commonly located in head and neck. They are congenital benign haemartomas of the lymphatic system. The most common location of intra oral lymphangiomas is the dorsum of the tongue. The lymphangiomas are amicable to surgical excision. Large oral lymphangiomas can decrease the already small mouth opening in the neonates and cause difficulty in mask ventilation, laryngoscopy and intubation. The postoperative challenges include laryngospasm and airway obstruction compounded by the large tongue and the airway odema caused by the surgical manipulations. Providing a safe anesthesia in such challenging cases necessitate awareness of the anesthetic complications and necessary steps to prevent them. In this case report we present a case of large oral lymphangioma in a newborn and discuss the peri operative and anesthetic management.