Description:

The Laryngeal Mask Airway is an alternative airway device used for anesthesia and airway support. It consists of an inflatable silicone mask and rubber connecting tube. It is inserted blindly into the pharynx, forming a low-pressure seal around the laryngeal inlet and permitting gentle positive pressure ventilation. All parts are latex-free.

Indications:

The Laryngeal Mask Airway is an appropriate airway choice when mask ventilation can be used but endotracheal intubation is not necessary.

Contraindications:

• Non-fasted patients
  
• Morbidly obese patients
• Obstructive or abnormal lesions of the oropharynx

Advantages:

• Allows rapid access
• Does not require laryngoscope
• Relaxants not needed
• Provides airway for spontaneous or controlled ventilation
• Tolerated at lighter anesthetic planes

Disadvantages:

• Does not fully protect against aspiration in the non-fasted patient
• Standard LMA does not allow high positive pressure ventilation
• Requires re-sterilization

Special Features:

• May be used as a rescue airway and fiberoptic conduit when intubation is difficult, hazardous or unsuccessful
• It can be used for bronchoscopy in the awake or asleep patient
  

Tips for Success:

• Begin with ASA I & II patients
• Learn and use standard insertion technique
• Use appropriate size and do NOT overinflate
• Maintain adequate anesthetic depth
• Remove when the patient opens mouth to command

Currently available devices include:

• LMA-Classic™
• LMA-Flexible™
• LMA-Unique™
• LMA-ProSeal™

  For additional information contact LMA North America, Inc.

References:

1. Pennant JH, White PF. "The Laryngeal Mask Airway. Its Uses in Anesthesiology." Anesthesiology 79:144, 1993.

2. Benumof JL. "Laryngeal Mask Airway and the ASA Difficult Airway Algorithm." Anesthesiology 84:686, 1996.

3. Brimacombe JR, Brain AIJ. The Laryngeal Mask Airway: A Review and Practical Guide. WB Saunders, 1997.
   

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