Simultaneous use of two laryngoscop

Russell, S.H.; Hirsch, N.

doi:10.1111/j.1365-2044.1993.tb07437.x

Cited by 9 publications

(1 citation statement)

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“…There are several reports of failure of ventilation through the laryngeal mask in patients with difficult airways. 41,192,[209][210][211] If place-ment fails, ventilation through a face-mask is required, which is also not always successful. In addition, the laryngeal mask may not always be replaced if it becomes dislodged: muscle relaxation decreases the pharyngeal integrity,212 which may make placement difficult.…”

Section: Elective Usementioning

confidence: 99%

The laryngeal mask airway: its features, effects and role

1994

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The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anaesthetic practice. Numerous articles and letters about the device have been published in the last decade, but few large controlled trials have been performed. Despite widespread use, the definitive role of the laryngeal mask has yet to be established. In some situations, such as after failed tracheal intubation or in anaesthesia for patients undergoing laparoscopic or oral surgery, its use is controversial. There are a number of unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoid pressure prevents placement of the mask. We review the techniques of insertion, details of misplacement, and complications associated with the use of the laryngeal mask. We discuss the features and physiological effects of the device, including the changes in intra-cuff pressure during anaesthesia and effects on blood pressure, heart rate and intra-ocular pressure. We then attempt to clarify the role of the laryngeal mask in airway management during anaesthesia, based on the current knowledge, by discussing the advantages and disadvantages as well as the indications and contraindications of its use. Lastly we describe the use of the laryngeal mask in circumstances other than airway maintenance during anaesthesia: fibreoptic bronchoscopy, tracheal intubation through the mask and its use in cardiopulmonary resuscitation.

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Section: Elective Usementioning

confidence: 99%

The laryngeal mask airway: its features, effects and role

1994

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Intubation Techniques for Unanticipated Difficult Direct Laryngoscopy: Stylets and Introducers

Henderson¹

2004

Management Des Schwierigen Atemwegs

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The unanticipated difficult airway with recommendations for management

et al. 1998

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The unanticipated difficult airway with recommendations for managementPurpose: To review the current literature and generate recommendations on the role of newer technology in the management of the unanticipated difficult airway. Methods: A literature search using key words and filters of English language and English abstracted publications from contained in the Medline, Current Contents and Biological Abstracts databases was carried out. The literature was reviewed and condensed and a series of evidence-based recommendations were evolved. Conclusions: The unanticipated difficult airway occurs with a low but consistent incidence in anaesthesia practice. Difficult direct laryngoscopy occurs in 1,5 -8.5% of general anaesthetics and difficult intubation occurs with a similar incidence. Failed inubation occurs in 0.13-0.3% general anaesthetics. Current techniques for predicting difficulty with laryngoscopy and intubation are sensitive, non-specific and have a low positive predictive value. Assessment techniques which utilize multiple characteristics to derive a risk factor tend to be more accurate predictors. Devices such as the laryngeal mask, lighted styler and rigid fibreoptic laryngoscopes, in the setting of unanticipated difficult airway, are effective in establishing a patent airway, may reduce morbidity and are occasionally lifesaving. Evidence supports their use in this setting as either alternatives to facemask and bag ventilation, when it is inadequate to support oxygenation, or to the direct laryngoscope, when tracheal intubation has failed, Specifically, the laryngeal mask and Combitube TM have proved to be effective in establishing and maintaining a patent airway in "cannot ventilate" situations. The lighted stylet and Bullard (rigid) fibreoptic scope are effective in many instances where the direct laryngoscope has failed to facilitate tracheal intubation. The data also support integration of these devices into strategies to manage difficult airway as the new standard of care. Training programmes should ensure graduate physicians are trained in the use of these alternatives. Continuing medical education courses should allow physicians in practice the opportunity to train with these alternative devices.Objectif : Passer en revue la documentation courante et fournir des recommandations sur le r61e de la nou velle technologie dans la conduite ~ tenir Iors d'une intubation difficile. M~thodes : On a procEdE ~ une recherche documentaire selon des mots-clEs et des filtres de langue anglaise et des publications de rEsumEs anglais de 1990 ~ 1996, contenus dans les bases de donnEes de Medline, Current Contents et Biolo~colAbstracts.La littErature a ErE revue et r&umEe et une sErie de recommandations basEes sur les fairs ont ErE ElaborEes. Conclusion : Les dit~cultEs d'intubation non prEvues surviennent selon une incidence faible, mais constante, clans la pratique de I'anesthEsie, Des probl~mes de laryngoscopie directe et des difficult& d'intubation ont lieu dans 1,5 -8,5 % des anesth&ies gEnErales. E&hec de I'...

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Simultaneous use of two laryngoscop

Abstract: References

Cited by 9 publications

References 0 publications

The laryngeal mask airway: its features, effects and role

The laryngeal mask airway: its features, effects and role

Intubation Techniques for Unanticipated Difficult Direct Laryngoscopy: Stylets and Introducers

The unanticipated difficult airway with recommendations for management

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