Laryngeal masks are supraglottic airway devices developed in the early 1980s. Today, they are frequently used in clinical routine to provide airway access for mechanical ventilation in patients undergoing surgery with a short duration. Moreover, the they have also become integral part of difficult airway management in patients who cannot be intubated by the use of conventional laryngoscopy.Relevant advances have been made to simplify their positioning and improve tightness with the aim to allow for the use of higher airway pressures during mechanical ventilation thereby reducing the risk of gastric insufflation and pulmonary aspiration. Focusing on this goal, several different prototypes have been developed and introduced in clinical practice until today. However, even these new developed laryngeal masks still do not provide reliable protection against pulmonary aspiration until today. Consequently, their use In critical care medicine is still limited to rescue situations with intubation failure.In this review some of the most popular lanryngeal masks are presented, indications for their use are outlined and their handling is described.
Background: Ciprofol, a novel intravenous anesthetic, exhibits similar sedation mechanisms and pharmacokinetic properties to propofol. However, ciprofol demonstrates greater potency and is associated with reduced injection pain compared to propofol. Given the varying sensitivities to anesthetic agents across different age groups, this study aims to determine the median effective dose (ED) of ciprofol required to suppress the laryngeal mask airway (LMA) insertion response in both young and older adult patients, as well as to assess its potential adverse reactions.
Introduction: The effectiveness of supraglottic airway devices (SGDs) as a strategy for blind endotracheal intubation (ETI) was compared in this study.
Methods: A systematic review of clinical trials (CTs) involving SGDs for blind ETI in patients under general anesthesia or simulation manikins, was conducted. CTs that used SGDs for fiberoptic-guided ETI and those conducted in children were excluded.
The study aimed to identify anesthetic agents that reduce negative outcomes during laryngeal mask airway (LMA) insertion in adult patients receiving general anesthesia.
A network meta-analysis of 53 randomized controlled trials involving 4695 patients found that the combination of propofol and dexmedetomidine was most effective in minimizing adverse events during the procedure.
Overall, all anesthetic combinations, except for those involving thiopental, were better than propofol alone in reducing adverse outcomes related to apnea, insertion failure, and inadequate anesthesia depth.
Study Objective: Second-generation laryngeal mask airways are equipped with an additional lumen for a gastric tube, with the intention to reduce the risk of aspiration by draining gastric content. However, the effect of an inserted gastric tube through the gastric channel on gastric insufflation, a substantial part of the pathomechanism of aspiration, during positive-pressure ventilation is not clear. We hypothesized, that an inserted gastric tube increases the risk of gastric insufflation.
Emergence delirium, characterised by inconsolable crying, perceptual disturbances and thrashing, occurs in young children during the recovery phase from general anaesthesia. Our aim was to determine whether timing of laryngeal mask airway removal (deeply anaesthetised versus awake) influenced the incidence of emergence delirium in children after tonsillectomy. A single-centre, randomised controlled trial was conducted at Albury Wodonga Health, a regional hospital in Australia.
