Airway Rescue using the LMA Supreme™ in the prone position: a case report

Massimiliano Sorbello, Ivana Zdravkovic, Massimiliano Veroux, Ruggero Massimo Corso

DOI: https://doi.org/10.7175/cmi.v9i3.1186

Abstract

Surgery in prone positioning may pose considerable challenges to Anesthesiologists because of general accessibility to the patient; this is particularly true if referring to airway management, because the airway could be relatively inaccessible while the patient is lying prone.

We report a case of an obese women scheduled for lower limbs surgery in the prone position in which the initial anesthetic choice for spinal anesthesia needed to be switched to general anesthesia during the procedure both for the occurrence of surgical complications and because the patient began to become uncooperative. We successfully managed this problem by inserting a LMA SupremeTM leaving the patient in the same prone position, and maintaining anesthesia in mechanical ventilation, thus allowing surgical procedure to be completed uneventfully. The possible options in similar cases and the specific features of LMA SupremeTM which allowed such a choice are discussed.

Keywords

Airway Rescue; LMA Supreme™; Prone position; Anesthesia

Full Text

HTML PDF

References

  • Van Zundert A, Brimacombe J. The LMA Supreme TM – a pilot study. Anesthesia 2008; 63: 209-10; http://dx.doi.org/10.1111/j.1365-2044.2007.05421.x
  • SIAARTI Difficult Airways Study Group. Task Force: Petrini F, Guarino A, Merli G, et al. Recommendations for airway control and difficult airway management. Minerva Anestesiologica 2005; 71: 617-56
  • Attari MA, Mirhosseini SA, Honarmand A, et al. Spinal anesthesia versus general anesthesia for elective lumbar spine surgery: A randomized clinical trial. J Res Med Sci 2011; 16: 524-9
  • Jellish WS, Shea JF. Spinal anesthesia for spinal surgery. Best Pract Res Clin Anaesthesiol 2003; 17: 323-34; http://dx.doi.org/10.1016/S1521-6896(02)00115-5
  • Neal MR, Groves J, Gell IR. Awake fibreoptic intubation in the semi-prone position following facial trauma. Anesthesia 1996; 51: 1053-4; http://dx.doi.org/10.1111/j.1365-2044.1996.tb15004.x
  • Hung MH, Fan SZ, Lin CP, et al. Emergency airway management with fiberoptic intubation in the prone position with a fixed flexed neck. Anesth Analg 2008; 107: 1704-6; http://dx.doi.org/10.1213/ane.0b013e3181831e2e
  • Maitra S, Khanna P, Baidya DK. Comparison of laryngeal mask airway Supreme and laryngeal mask airway Pro-Seal for controlled ventilation during general anaesthesia in adult patients: systematic review with meta-analysis. Eur J Anaesthesiol 2014; 31: 266-73; http://dx.doi.org/10.1097/01.EJA.0000435015.89651.3d
  • Whitacre W, Dieckmann L, Austin PN. An update: use of laryngeal mask airway devices in patients in the prone position. AANA J 2014; 82: 101-7
  • Raphael J, Rosenthal-Ganon T, Gozal Y. Emergency airway management with a laryngeal mask airway in a patient placed in the prone position. J Clin Anesth 2004; 16: 560-1; http://dx.doi.org/10.1016/j.jclinane.2004.03.004
  • Dingeman RS, Goumnerova LC, Goobie SM. The use of a laryngeal mask airway for emergent airway management in a prone child. Anesth Analg 2005; 100: 670-1; http://dx.doi.org/10.1213/01.ANE.0000146512.48688.FA
  • Abrishami A, Zilberman P, Chung F. Brief review: Airway rescue with insertion of laryngeal mask airway devices with patients in the prone position. Can J Anaesth 2010; 57: 1014-20; http://dx.doi.org/10.1007/s12630-010-9378-1
  • López AM, Valero R, Hurtado P, et al. Comparison of the LMA Supreme™ with the LMA Proseal™ for airway management in patients anaesthetized in prone position. Br J Anaesth 2011; 107: 265-71; http://dx.doi.org/10.1093/bja/aer104
  • López AM, Valero R, Brimacombe J. Insertion and use of the LMA Supreme in the prone position. Anaesthesia 2010; 65: 154-7; http://dx.doi.org/10.1111/j.1365-2044.2009.06185.x
  • Sharma V, Verghese C, McKenna PJ. Prospective audit on the use of the LMA-Supreme for airway management of adult patients undergoing elective orthopedic surgery in prone position. Br J Anaesth 2010; 105: 228-32; http://dx.doi.org/10.1093/bja/aeq118
  • Charters P, O’Sullivan E. The ‘dedicated airway’: a review of the concept and an update of current practice. Anesthesia 1999; 54: 778-86; http://dx.doi.org/10.1046/j.1365-2044.1999.00888.x
  • Mathes AM, Wrobel M, Reus E, et al. Fiberoptic-guided intubation via the Laryngeal Mask Airway Supreme. J Clin Anesth 2008; 20: 322-3; http://dx.doi.org/10.1016/j.jclinane.2008.03.002
  • Woodall NM, Cook TM. National census of airway management techniques used for anaesthesia in the UK: first phase of the Fourth National Audit Project at the Royal College of Anaesthetists. Br J Anaesth 2011; 106: 266-71; http://dx.doi.org/10.1093/bja/aeq339

Statistics

Abstract: 1743 views
HTML: 1804 views
PDF: 340 views

Refbacks

  • There are currently no refbacks.