Postoperative Pulmonary Aspiration of Gastric Contents in an Infant After General Anesthesia with Laryngeal Mask Airway (LMA)

Aspiration and the laryngeal mask airway: three cases and a review of the literature †

“…We found a total of 20 specifically described case reports of aspiration of gastric content associated with the LMA (Table 1). Of the 20 cases of aspiration associated with the LMA, 14 were in adults [6][7][8][9][10][11][12][13][14][15][16][17][18] and six in children, [19][20][21][22][23][24] 19 were with the classic LMA 6-17 [19][20][21][22][23][24] and one was with the ProSeal LMA. 18 In 14 cases, there were factors that could increase the risk of aspiration, including, in order of frequency, inadequate depth of anaesthesia, 9 13 19 21 23 intra-abdominal surgery, 7 10 18 upper gastrointestinal disease, 9 11 lithotomy position, 11 20 patient movement, 7 20 exchanging the LMA for a tracheal tube, 12 16 full stomach, 22 multiple trauma, 6 multiple insertion attempts, 14 opioids, 6 obesity, 10 and cuff deflation.…”

“…7 There is only one report where aspiration occurred where the patient had no risk factors. 24 In addition, Kluger and Short, 25 in a review of 133 cases of aspiration reported to the Australian Anaesthetic Incident Monitoring Study, documented 27 cases of aspiration associated with the LMA. However, the data from these patients were not separated from aspiration associated with a tracheal tube (n=8), Hudson mask (n=5), and facemask (n=91).…”