Re-evaluation of Appropriate Size of the Laryngeal Mask Airway

Murao, Kohei; Yukawa, Hisaya; Siungu, K.

doi:10.1097/00132586-200006000-00051

Cited by 7 publications

(11 citation statements)

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“…It is not known whether there is any difference in the efficacy of the laryngeal tube between height‐ and weight‐based selection in this group of patients. Similar difficulty has been found for the laryngeal mask airway in selecting an appropriate size in small adults [10]. Although we selected the size 4 based on the patients' height, almost all patients included in this study were within the manufacturer's suggested range for a size 4 tube of 50–90 kg.…”

Section: Discussionmentioning

confidence: 84%

Efficacy of the laryngeal tube during intermittent positive‐pressure ventilation

Murao

Shingu

2000

Anaesthesia

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SummaryWe studied the efficacy of the laryngeal tube (VBM, Germany) during intermittent positivepressure ventilation in 50 patients. After induction of anaesthesia and neuromuscular blockade, a size 4 laryngeal tube was inserted for patients of height 155 cm or greater. After insertion of the laryngeal tube, its pharyngeal and oesophageal balloons were inflated to an intracuff pressure of 60 cmH 2 O. An Ambu self-inflating bag was attached to the laryngeal tube and the lungs were ventilated manually at 15 breath.min . We conclude that the laryngeal tube has a potential role in airway management during intermittent positive-pressure ventilation for anaesthesia or cardiopulmonary resuscitation.

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Section: Discussionmentioning

confidence: 84%

Efficacy of the laryngeal tube during intermittent positive‐pressure ventilation

Murao

Shingu

2000

Anaesthesia

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“…There are accumulating evidences supporting the use of LMA size 4 for females and size 5 for males. AS a sex-related formula is a more successful strategy than the manufacturer′s weight-based recommendations in avoiding air leak from the gap between the mask and pharynx[ 9 18 19 ] This also was found to decrease the incidence of postoperative airway complications resulting from pharyngeal wall ischemia and lingual nerve injury due to over inflation of small size LMA. [ 20 ]…”

Section: Discussionmentioning

confidence: 99%

Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

et al. 2010

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BackgroundLow flow anesthesia can lead to reduction of anesthetic gas and vapor consumption. Laryngeal mask airway (LMA) has proved to be an effective and safe airway device. The aim of this study is to assess the feasibility of laryngeal mask airway during controlled ventilation using low fresh gas flow (1.0 L/min) as compared to endotracheal tube (ETT).Patients and MethodsFifty nine non-smoking adult patients; ASA I or II, being scheduled for elective surgical procedures, with an expected duration of anesthesia 60 minutes or more, were randomly allocated into two groups - Group I (29 patients) had been ventilated using LMA size 4 for females and 5 for males respectively; and Group II (30 patients) were intubated using ETT. After 10 minutes of high fresh gas flow, the flow was reduced to 1 L/min. Patients were monitored for airway leakage, end-tidal CO2(ETCO2), inspiratory and expiratory isoflurane and nitrous oxide fraction concentrations, and postoperative airway-related complications.ResultsTwo patients in the LMA-group developed initial airway leakage (6.9%) versus no patient in ETT-group. Cough and sore throat were significantly higher in ETT patients. There were no evidences of differences between both groups regarding ETCO2, uptake of gases, nor difficulty in swallowing.Conclusion:The laryngeal mask airway proved to be effective and safe in establishing an airtight seal during controlled ventilation under low fresh gas flow of 1 L/min, inducing less coughing and sore throat during the immediate postoperative period than did the ETT, with continuous measurement and readjustment of the tube cuff pressure.

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“…Several researchers have attempted to find a method for selecting an appropriate size of the laryngeal mask [7–11]. Voyagis and colleagues found that the mask provided a better airtight seal during controlled ventilation using the sex‐related selection method (size 4 in females and size 5 in males) than the weight‐related method (size 3 in patients weighing < 70 kg, size 4 for patients weighing 70–90 kg and size 5 for patients weiging > 90 kg) [7].…”

Section: Appropriate Sizementioning

confidence: 99%

“…If the cuff is in the oral cavity, it may interfere with tonsillectomy and may increase the theoretical risk of sore throat or ischaemic change to lingual nerves. One study showed that when a larger laryngeal mask was used, the cuff was often seen in the back of the mouth in small patients (< 165–170 cm in height in males and 160–165 cm in females) [11]. This was consistent with another study, which concluded that, in patients who were < 165 cm in height, the size 4 would be more appropriate than the size 5, in terms of oropharyngeal sealing pressure and the fibreoptic position of the mask [8].…”

Section: Appropriate Sizementioning

confidence: 99%