Laryngeal mask airway

The laryngeal mask airway (synonyms: laryngeal mask, " laryngeal mask airway " (LMA ), Brain- tube) is a means to hold open the airways in anesthesia during anesthesia. It was developed by the British anesthetist Archibald Brain in 1981 and introduced into clinical practice. At the other end of the laryngeal mask airway can be connected to a ventilator unit with which spontaneous breathing with increased oxygen content or manual or mechanical ventilation are possible. In Germany it is legal for simple anesthesia as a substitute for the face mask since 1991.

Advantages, application profile

With respect to the face mask has the advantage to better seal the upper airway. In addition, the anesthetist 's hands free. In contrast to endotracheal intubation, however, no endotracheal tube must be placed on the vocal cords passing in the trachea. The laryngeal mask airway is only until just pushed over the larynx and there sealed with an inflatable Luftwulst. Typical complications of intubation, such as hoarseness or injuries caused by the laryngoscope can be largely avoided with the use of the laryngeal mask airway. The laryngeal mask airway is therefore mostly used for shorter interventions in fasting patients. In addition, however, it is also firmly embedded in algorithms of the difficult airway management and is (in addition to alternatives such as the laryngeal tube or Combitube ), when the bag - mask ventilation and endotracheal intubation not succeed.

Limitations and side effects

As with the simple face mask during anesthesia with the laryngeal mask airway in principle a risk of aspiration ( inhalation) of gastric contents, because the trachea and esophagus are not separated. In addition, ventilation can inflate the stomach with too much pressure.

A not uncommon side effect after use of the laryngeal mask are sore throat of the patient caused by the foreign body in the throat. At high Insufflationsdrücken the air cushion and prolonged use pharyngeal mucosa and extending into the surrounding soft tissues, nerves can be damaged.

Modifications

Originally developed by A. Brain laryngeal mask was modified several times. In addition to the reusable laryngeal mask airway laryngeal masks are disposable in use, as well as devices with additional channels can be inserted through the gastric tube.

The Intubationslarynxmaske ( ILMA ) allows the subsequent insertion of an endotracheal tube through the already inserted mask and is used for difficult intubation. So can be the intubation of an already anesthetized and controlled ventilated patients. A failure to subsequent intubation, you still have the opportunity to ventilate the patient with the underlying ILMA.