A technique to improve the safety of laryngeal mask airway when used in lacrimal duct surgery.
BACKGROUND
Congenital obstruction of the lacrimal drainage system is present in approximately 6% of newborn. Syringing and probing is one of the common interventional modalities for this condition. Current literature states that syringing and probing is performed best with general anesthesia with tracheal intubation. We study a technique to improve the safety and efficacy of the laryngeal mask airway (LMA) in lacrimal duct surgery.


METHODS
Sixty-five ASA grade I-II patients between 6 months and 10 years scheduled for syringing and probing were included after informed consent was obtained from the parents. After induction of anesthesia and confirmation of LMA position, a transparent suction catheter was inserted into the hypopharynx. Continuous suction was applied to the catheter. A total of 2-3 ml of 0.01% povidone-iodine solution was used for syringing. Staining of the catheter was regarded as a sign of patency of the duct.


RESULTS
None of our patients had perioperative airway or respiratory complications.


CONCLUSIONS
Based on the results of our study, we suggest that the LMA can safely be used in lacrimal duct procedures. Using 0.01% povidone-iodine as irrigation fluid further increases the margin of safety.
Sunder
Rani A
RA
Department of Anaesthesiology and Intensive care, All India Institute of Medical Sciences, New Delhi, India. rani_kannan2000@yahoo.com
Joshi
Chittaranjan
C
D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D002404:Catheterization / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003608:Dacryocystorhinostomy; D006801:Humans; D007223:Infant; D007455:Iodine / Q000008:administration & dosage; D017214:Laryngeal Masks / Q000009:adverse effects*; D010592:Pharmaceutic Aids / Q000008:administration & dosage; D011205:Povidone / Q000008:administration & dosage; D013396:Suction / Q000379:methods; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D010592:Pharmaceutic Aids; D007455:Iodine; D011205:Povidone