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Canadian Journal of Anesthesia 49:413 (2002)
© Canadian Anesthesiologists' Society, 2002
Cardiothoracic Anesthesia, Respiration and Airway

Aspiration prevented by the ProSealTM laryngeal mask airway: a case report

[Prévention de l'aspiration par le masque laryngé ProSealTM : une étude de cas]

Niall R. Evans, MBCHB DA(SA), Richard L. Llewellyn, MBCHB FCA(SA), Susan V. Gardner, MB CHB FCA(SA) and Michael F.M. James, FRCA FCA(SA)

From the Department of Anaesthesia, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, South Africa.

Dr. Niall R. Evans, Department of Anaesthesia, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa. Phone: +27-828986891; Fax: +27-821318986891; E-mail: niall{at}wol.co.za

Objectif : Décrire un cas de régurgitation peropératoire passive où le masque laryngé ProSealTM (MLP) a permis de protéger efficacement les voies aériennes du contenu gastrique.

Éléments cliniques : Le changement des pansements et l'application de plâtre de Paris aux deux jambes avaient été planifiés pour un homme de 32 ans. Un MLP 5 a été inséré au premier essai et le patient a pu respirer spontanément. Vingt-cinq minutes après le début de l'intervention, un liquide brunâtre a été noté dans le tube de drainage du masque. La respiration n’était pas affectée et aucune évidence de haut-le-coeur ou de vomissement n’était observée. Vingt-cinq millilitres de liquide ont été aspirés du tube et une analyse en a révélé un contenu acide. Le MLP a été laissé en place et l'intervention s’est poursuivie sans incident. Après le retrait du masque, un test de pH a montré que le bord dorsal du masque présentait un pH de 7 et la partie ventrale/creuse était sèche et avait un pH de 7. À la salle de réveil, le patient n’avait pas de symptômes respiratoires et la récupération s’est déroulée normalement.

Conclusion : Ce cas illustre le fait qu'une régurgitation passive puisse se produire de façon inattendue pendant une intervention et que le MLP peut alors protéger les voies aériennes en permettant au liquide régurgité de passer dans le tube de drainage sans aller dans la glotte.




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This Article
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Right arrow Articles by James, M. F.M.

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