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LARYNGEAL MASK AIRWAY (LMA)

LARYNGEAL MASK AIRWAY (LMA). Dr. Rupak Bhattarai Taishan Medical University. Laryngeal Mask Airway. It is being increasingly used in place of a face mask or tracheal tubes during administration of an anesthetic, to facilitate ventilation. Also used in patients with difficult intubation.

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LARYNGEAL MASK AIRWAY (LMA)

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  1. LARYNGEAL MASK AIRWAY (LMA) Dr. RupakBhattarai Taishan Medical University

  2. Laryngeal Mask Airway • It is being increasingly used in place of a face mask or tracheal tubes during administration of an anesthetic, to facilitate ventilation. • Also used in patients with difficult intubation.

  3. PARTS OF LMA • THE CUFF • THE APERTURE BARS • THE AIRWAY TUBE • THE CONNECTOR • THE INFLATION LINE • THE PILOT BALOON • THE VALVE

  4. Types of LMA Generally four types of LMA used these days: • The re-usable LMA • The disposable LMA • The proseal LMA which has an orifice through which naso -gastric tube can be inserted • Fastrach LMA that facilitates intubating patients with difficult airways.

  5. PROSEAL AND FASTRACH

  6. An LMA consists of a wide bore tube whose proximal end connects to a breathing circuit and the distal end is attached to an elliptical cuff that can be inflated through a pilot tube.

  7. Procedure of insertion of LMA • The deflated cuff is lubricated and inserted blindly into the hypopharynx so that once inflated ,the cuff forms a pressure seal around the entrance to the larynx. • This requires the anesthetic depths slightly greater than the required for the insertion of an oral airway. • The shaft of an LMA can be secured with tape. • The re-usable LMA , which can be used after autoclave is made of silicon rubber and is available in many sizes.

  8. INTERNAL VIEW OF PLACEMENT OF LMA

  9. Sizes of LMA No 1 : For infant with weight less than 6.5 kg. No2 : Child with weight 6.5-20 kg. No 2.5 : Child with weight 20-30 kg. No 3 : Small adult with weight greater than 30 kg. No 4 :Normal adult with weight less than 70 kg. No 5 : Large adult with weight greater than 70 kg.

  10. Cuff volume (ml) for LMA • No 1 : 2-4 ml • No 2: Up to 10 ml • No 2.5: Up to 15 ml • No 3 : Up to 20 ml • No 4: Up to 30 ml • No 5 : Up to 30 ml

  11. Contraindication for LMA insertion • Pharyngeal pathology (e.g abscess). • Pharyngeal obstruction . • Full stomach patient. • Pregnancy. Although LMA is clearly not a substitue for tracheal intubation but it has proven particularly helpful as a temporizing measure in patients with difficult airways because of its easy of insertion and relatively high success rate (95-99%).

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