Use of the laryngeal mask for management of the compromised airway--a case report.
A 54-year old woman was scheduled for thoracotomy for excision of a tumor of the left upper lobe. Reduced thyromental distance and thyroid enlargement were identified by the preoperative physical examination and inability to visualize the larynx was encountered during direct laryngoscopy. A 37-Fr left sided double lumen tube was inserted in trachea with great difficulty after three failed attempts. One lung anesthesia underwent uneventfully and postoperatively it was decided to exchange the double lumen tube to a single lumen tracheal tube. After the extubation, five failed attempts of reintubation were performed. A laryngeal mask airway (LMA) size 3 was passed easily achieving an airtight airway. The patient underwent an uneventful prolonged (105 min) weaning via the LMA which was left in place until the patient regained full consciousness. Peripheral oxygen saturation remained greater than 95% throughout the airway manipulation. LMA insertion is an easy non-invasive technique and should be considered whenever airway management proves difficult.
Voyagis
G S
GS
Department of Anesthesiology, Laikan and Soticia Hospitals, Athens, Greece.
Palumbi
C
C
D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D008875:Middle Aged; D013908:Thoracotomy