Background: The laryngeal mask airway (LMA) has been used in adult and pediatric populations for decades. While the familiarity of its use in the neonatal population is increasing, there are few data investigating this.
Objective: The objective of this study was to determine the feasibility of LMA placement in neonates by investigating the time and number of attempts required for successful placement and physiologic stability during the placement of the device.
Methods: This study is one component of a national, multicenter, randomized controlled trial investigating surfactant administration through an LMA in neonates. Videotape of LMA placement was reviewed to determine the total procedure time and the number of attempts required to successfully place the device. Heart rate and oxygen saturation (SaO2) were analyzed as change from baseline, in order to examine physiologic stability during device placement.
Results: Videotape and physiologic data were analyzed for 36 infants. Gestational age ranged from 293/7 to 354/7 weeks (mean 33 ± 1.7) with the birth weight ranging from 1,290 to 3,180 g (mean 2,006 ± 482). Average total procedure time was 88 s (±136) with 64% of the procedures successfully completed in <35 s. Successful placement was achieved on the first attempt in 69% of the cases. Compared to baseline, heart rate increased by an average of 1 bpm (±4.5) and SaO2 decreased an average of 6% (±7).
Conclusions: Successful placement was achieved in the majority of patients in <35 s and required only one attempt. Physiologic parameters were maintained close to baseline, measured by minimal fluctuation in heart rate and SaO2 during the procedure. Placement of the LMA is feasible in neonates.
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http://dx.doi.org/10.1159/000450691 | DOI Listing |
Ugeskr Laeger
December 2024
Øre-Næse-Hals-Afdelingen, Københavns Universitetshospital - Nordsjællands Hospital, Hillerød.
This is a case report of a rare hypoglossal nerve paresis after tonsillectomy in a healthy 29-year-old woman. While she made a full recovery, she experienced 6-8 weeks of dysphagia, dysarthria and had to be readmitted because of dehydration. As direct intraoperative trauma is unlikely due to the protected course of the nerve, we discuss possible mechanisms and suggest precautions to avoid similar neuropraxia - such as avoiding overinflation of the laryngeal mask airway, regularly relieving the tongue pressure and using careful manipulation of the tongue base if necessary.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Department of Anesthesiology, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215124, China.
Background: Intravenous anesthesia with high-flow nasal cannula (HFNC) has been reported to benefit oxygen reserves and enhance postoperative recovery in surgeries requiring low neuromuscular blockade. This study investigated whether HFNC improves recovery quality in elderly undergoing ureteroscopic holmium laser lithotripsy (UHLL).
Methods: We enrolled 106 elderly patients undergoing UHLL, with 96 patients (48 per group) included in the final analysis.
Front Med (Lausanne)
December 2024
Department of Anaesthesiology and Intensive Therapy, Medical University of Lodz, Łódź, Poland.
Background: The Laryngeal Mask Airway Vision Mask (LMA VM) is a supraglottic airway device (SAD) with a vision guidance system. The ideal head and neck position for direct laryngoscopy is known, but the ideal position for placing a LMA is not. The objective of this study is to evaluate and compare the optimal position for placement of a video laryngeal mask airway.
View Article and Find Full Text PDFBMC Pulm Med
December 2024
Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, 400,014, China.
Purpose: To compare five pulmonary surfactant (PS) administration strategies for neonates with respiratory distress syndrome (RDS), including intubation-surfactant-extubation (InSurE), thin catheter administration, laryngeal mask airway (LMA), surfactant nebulization (SN), and usual care, with a particular emphasis on the comparison of the LMA and SN with other strategies.
Methods: We conducted a systematic search of MEDLINE, EMBASE, PUBMED, and Cochrane CENTRAL databases up to November 2023. Two authors independently conducted data extraction, and assessed bias using the Cochrane Risk of Bias Tool.
J Clin Anesth
December 2024
Department of Anesthesiology, Cancer Hospital Chinese Academy of Medical Sciences, Beijing 100021, China. Electronic address:
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