title: The use of a laryngeal mask airway for emergent airway management in a prone child.
abstract: A 5-yr-old girl with Arnold-Chiari Malformation, Type 1, was accidentally tracheally extubated while positioned prone in a Mayfield neurosurgical headrest during a decompressive craniectomy and cervical laminectomy. While preparations were being made to return the patient to the supine position for reintubation, we placed a laryngeal mask airway (LMA) without difficulty. The child was kept in the prone position with the LMA in place using positive-pressure ventilation for the remainder of the operation. This case report emphasizes the practical, emergent use of a LMA to secure the airway of a pediatric patient in the prone position after accidental extubation.
authors.affiliation: Departments of Anesthesiology, Perioperative and Pain Medicine and Neurosurgery; Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts.
authors.forename: R Scott
authors.initials: RS
authors.lastname: Dingeman
authors.forename: Liliana C
authors.initials: LC
authors.lastname: Goumnerova
authors.forename: Susan M
authors.initials: SM
authors.lastname: Goobie
mesh_terms: D002675:Child, Preschool; D004630:Emergencies; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D016684:Prone Position
references.citation: Ng A, Raitt DG, Smith G. Induction of anesthesia and insertion of a laryngeal mask airway in the prone position for minor surgery. Anesth Analg 2002;94:1194–8.
references.citation: Osborn IP, Cohen J, Soper RJ, Roth LA. Laryngeal mask airway: a novel method of airway protection during ERCP: comparison with endotracheal tube. Gastrointest Endosc 2002;56:122–8.