[Is the laryngeal mask a minimally invasive instrument for securing the airway? Supplementary remarks on the paper "Injures and dangers in the use of the laryngeal mask" by V. Hempel, Anaesthesist (1999)48:399-402].
Minor laryngopharyngeal complaints following anaesthesia considerably determine postoperative patient comfort. They cannot be eliminated but reduced by experience and careful preparation and insertion technique. The incidence of minor laryngopharyngeal symptoms following the use of the laryngeal mask airway is similar to that following endotracheal intubation. However, there seems to be a distinct pattern of complaints: discomfort with swallowing is more frequent after LMA, whereas dysphonia is more often observed following endotracheal intubation. The significance of LMA cuff pressures in the pathogenesis of postoperative throat complaints remains unclear. There is sound evidence that cuff pressure is not a representative measure for the effective pressure load upon the pharyngeal mucosa. Measurement of cuff pressure is not obligatory, instead reduction of cuff volume to a "just seal" situation seems to be a reasonable approach. The laryngeal mask airway has definitely changed anaesthesiology airway management. Whether this is due to its supposedly less invasiveness compared to endotracheal intubation has not been proven by scientific investigations.
Rieger
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A
Abteilung für Anästhesie und Intensivmedizin, DRK-Krankenhaus Neuwied. CUNeuwied@gmx.de
Brunne
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B
D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D017214:Laryngeal Masks / Q000009:adverse effects*; D007830:Larynx / Q000293:injuries*; D010614:Pharynx / Q000293:injuries; D011183:Postoperative Complications / Q000453:epidemiology