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The reinforced laryngeal mask airway (RLMA) protects the airway in patients undergoing nasal surgery – an observational study of 200 patients

[Le masque laryngé renforcé (MLR) protège les voies aériennes chez les patients qui subissent une opération au nez – une étude par observation de 200 patients]

From the Department of Anesthesia, Manchester Royal Infirmary, Manchester, UK.

Dr. M. Zubair Ahmed (consultant anaesthetist), Department of Anesthesia, St. Bartholomew’s Hospital, West Smithfield, London EC1A 7BE, UK. Phone: ++44 7811189495; Fax: ++44 2076017520; E-mail: zubair{at}cwcom.net

Purpose: The laryngeal mask airway (LMA) is used in nasal surgery but there is some concern of tracheal or laryngeal contamination with blood and secretions. We have evaluated the ability of the LMA to prevent airway contamination until full emergence from anesthesia.

Methods: Two hundred adults, ASA I–III patients, undergoing nasal surgery under general anesthesia were included in a prospective observational study. A reinforced LMA, sizes 3–5, was used during surgery and removed with its cuff inflated, in recovery, when the patients awoke. The LMA was examined on its laryngeal aspect for contamination of blood and secretions and scored (0–3) independently by two observers according to soiling (score of 0 = no blood; score of 1 = staining on the cuff; score of 2 = staining on the inside of mask; score of 3 = blood in the tube).

Results: The contamination scores were [n (%)]: 0 =174 (87%); 1 = 22 (11%); 2 = 4 (2%); 3 = 0 (0%).

Conclusion: Ninety-eight percent of patients had no or minimal contamination of the LMA. The 2% incidence of grade 2 LMA soiling is low and probably acceptable, since it did not result in symptoms of airway contamination. We suggest that the use of the LMA for nasal surgery may be appropriate.

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