A systematic review of case reports was conducted by searching PubMed,
Scopus, and Google scholar to identify case reports in which there is an
association between Myasthenia Gravis (MG) and Myeloproliferative
Neoplasms (MPNs) and know whether MG can be considered a possible
neurological paraneoplastic syndrome in patients with MPNs.
Background: The laryngeal mask airway (LMA) Supreme is a single-use, secondgeneration supra-glottic airway device that gained popularity because of its ease of insertion and higher sealing pressure. We report a case of intra-operative LMA supreme breakage in a patient with anticipated difficult airway. Case Report: A 41 year-old female patient with anticipated difficult airway was posted for modified radical mastectomy under general anesthesia utilizing LMA Supreme. After one hour of uneventful surgery significant air leak was noticed. After excluding all possible causes of air leak, while repositioning the LMA, we noticed a break in LMA. The airway was successfully rescued with an endotracheal tube (ETT) rail-roaded over a bougie inserted through the broken end of the LMA. The breakage could be attributed to inadvertently exerted pressure and remained unnoticed because the LMA was covered by surgical drapes. Conclusion: Continuous vigilance and preparedness to handle difficult airways throughout the procedure are essential to manage such cases.
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