THE USE OF THE LARYNGEAL MASK - A PRACTICAL METHOD IN ANESTHESIA

In 1985 Brain et al. published their first experience with the laryngeal mask, developed by themselves [1]. With this mask it is possible to seal the larynx and ventilate a patient during anesthesia without endotracheal intubation. Meanwhile, further reports of successful use have been published, especially in Great Britain [2-5, 7]. We decided to investigate this new anesthetic device. In 15 patients (ASA groups I and II) undergoing elective operations in the supine position the laryngeal mask was inserted after induction of anesthesia with propofol and alfentanil (Fig. 1). Positioning of the laryngeal mask was carried out as described by Brain [4]. In all patients the laryngeal masks could be inserted without any problems, manual ventilation of the patient was performed immediately, and ventilating pressures never exceeded 15 cm H2O. We observed neither complications related to airway control nor technical problems. Cardiovascular parameters and arterial oxygen saturations were always in the normal range (Fig. 2). In 3 patients quick movements of the head were carried out during repositioning of a fractured zytomatic arch, but no complications due to a possible changed position of the laryngeal mask occurred. Postoperatively two patients reported airway complaints such as sore throat. Our investigation confirmed the previously described advantages of the laryngeal mask. We consider its use to be especially indicated in general anesthesia for short surgical or diagnostic procedures or if specific complications of endotracheal intubation should be avoided [8]. A critical aspect in the use of the laryngeal mask is the fact that there is no complete isolation of the trachea and, therefore, an insufflation of the stomach or aspiration could occur, especially during critical situations (e.g. bronchospasms). In conclusion, we consider the laryngeal mask a useful new anesthetic device for selected patients.