title: Laryngeal Mask Airway and Valsalva Maneuver During Ophthalmic Surgery: A Case Report.
abstract: The use of a supraglottic airway, also called laryngeal mask airway (LMA), is gaining in popularity for delivery of general anesthesia in certain situations and is shown to be safe. Use of infraglottic airways (tracheal tubes) allows for positive pressure ventilation and maneuvers, such as holding continuous positive pressure in the airway to check for pleural and dural leaks. We describe the successful use of the LMA (Teleflex Inc) for general anesthesia, in which continuous positive airway pressure of 15 cm H2O held for 20 seconds allowed the neurosurgeon to identify the site of a cerebrospinal fluid (CSF) leak and successfully repair the leak. A well-seated LMA can be successfully used to produce continuous positive pressure in the airway not exceeding 20 cm H2O for 20 seconds to facilitate surgical identification of CSF leaks.
authors.affiliation: Anesthesiology Department at Mayo Clinic in Jacksonville, Florida.
authors.forename: Pamela
authors.initials: P
authors.lastname: Lovett
authors.affiliation: Anesthesiology Department at Mayo Clinic in Jacksonville, Florida.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Klingbeil
authors.affiliation: Neurosurgery Department at Mayo Clinic in Jacksonville, Florida.
authors.forename: Ronald
authors.initials: R
authors.lastname: Reimer
authors.affiliation: Anesthesiology Department at Mayo Clinic in Jacksonville, Florida.
authors.forename: Timothy
authors.initials: T
authors.lastname: Shine
mesh_terms: D000768:Anesthesia, General; D006801:Humans; D017214:Laryngeal Masks; D013508:Ophthalmologic Surgical Procedures; D011175:Positive-Pressure Respiration; D014636:Valsalva Maneuver
keywords: Valsalva maneuver; dural leak; laryngeal mask airway; positive pressure