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Laryngeal mask indications
1. Respiratory tract obstruction
1) Improper position of LMA, folding or rotation of the hood, excessive inflation of the hood, temperature rise or N2O diffusion will increase the capacity in the hood and close the glottis.
2) children with large tongue, high glottis position, large and soft epiglottis, often cover the pharynx, resulting in poor respiratory tract, the incidence of respiratory obstruction is nearly twice higher than that of adults.
2, reflux, aspiration
1) Anesthesia and surgery significantly reduced the tension of the upper and lower esophageal sphincter and normal physiological protective reflexes (cough, breath hold, etc.).
2) The volume of gastric juice in children is relatively large, the intragastric pressure is high, and the pH is low. Therefore, the risk of reflux and aspiration during anesthesia is relatively large.
3) LMA can not effectively isolate the esophagus and trachea, and it is easy to induce reflux aspiration when influenced by factors such as shallow anesthesia, operation and cough.
3. Air leakage around the throat mask
1) Poor matchup.
2) The model of laryngeal mask is not suitable.
3) Airway pressure is too high.
4) Insert too shallow or too deep.
4. Postoperative sore throat
1) The incidence of sore throat after laryngeal mask is very low, only 7% reported in literature.
2) Tracheal intubation can reach 47%.
3) Mask and oropharyngeal airway can reach 10%.
5. Laryngeal spasm
Cause: Insertion or removal of laryngeal mask under too shallow anesthesia can induce severe laryngeal spasm leading to airway negative pressure and lung injury; Stimulation such as surgery or sputum aspiration can also cause laryngeal reflex and laryngeal spasm.
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