[Flexible laryngeal mask airway use during surgical burn management with head mobilisation: a feasibility study].
OBJECTIVE
To evaluate the feasibility and reliability of the flexible laryngeal mask airway (LMA flexible) use during scalp skin harvesting for surgical reparation of burn sequella.


METHODS
Observational prospective descriptive study.


METHODS
Following local ethic committee approval, 26 patients were included in the study during their preanaesthesia visit. The general anaesthesia induction of each patient was followed by the insertion of a LMA flexible. The number of attempts required to insert the mask and the procedure were documented. The oropharyngeal leak pressure, expired tidal volume and end tidal CO(2) were recorded in five different head positions (neutral, hyperflexion, hyperextension, right and left rotation) at the start and end of surgical procedure. In all ten study periods of 2-3 min each were evaluated.


RESULTS
The airway device was inserted easily in all patients. While similar in four of the five head positions (neutral: 27.9+/-8.1 cmH(2)O, hyperextension, left and right rotation), the oropharyngeal leak pressure was significantly higher in the hyperflexion position (33.3+/-7.3 cmH(2)O). The end tidal volume was stable in all positions except hyperflexion (419+/-114 ml). While this value was significantly lower than the 471+/-68 ml recorded in the neutral position, it remained greater than 7 ml/kg. No significant change was observed for end tidal CO(2) for the ten study periods.


CONCLUSIONS
The use of LMA flexible during surgical burn repair procedures, including head mobilisation for the harvesting of scalp skin grafts is feasible.
Structure des urgences, hôpital Lapeyronie, 191, avenue du Doyen-Gaston-Giraud, CHRU de Montpellier, 34295 Montpellier, France. m-sebbane@chu-montpellier.fr
M
M
Sebbane
G
G
Chanques
M
M
Cisse
F
F
Lebreton
M
M
Brabet
R
R
Gartner
J
J
Rubenovitch
J-J
JJ
Eledjam
S
S
Jaber
D000328:Adult; D000368:Aged; D000399:Air Pressure; D000758:Anesthesia; D002056:Burns / Q000601:surgery*; D002245:Carbon Dioxide / Q000097:blood; D005240:Feasibility Studies; D005260:Female; D006257:Head / Q000502:physiology*; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D011187:Posture; D011229:Preanesthetic Medication; D012535:Scalp / Q000601:surgery*; D016038:Skin Transplantation; D013990:Tidal Volume; D055815:Young Adult
D002245:Carbon Dioxide