Complications associated with removal of the laryngeal mask airway: A comparison of removal in deeply anaesthetised versus awake patients

Abstract

Complications associated with removal of the laryngeal mask airway: a comparison of removal in deeply anaesthetised versus awake patientsThe purpose of the study was to compare the incidence of complications (coughing, biting, retching, vomiting

Timing of removal of the laryngeal mask airway

“…Previous studies showed that the incidence of complications associated with removal of the laryngeal mask was greater in awake patients than in anaesthetised patients [4][5][6][7]. However, the mask was removed apparently too early in 'awake' patients in some studies [5,7].…”

“…Several anaesthetists compared the incidence of complications associated with the removal of the laryngeal mask between 'anaesthetised' and 'awake' states of the patients and reported that the incidence was greater when the mask was removed in 'awake' patients than in 'anaesthetised' patients [4][5][6][7]. However, in none of these studies, did they follow the method of removal in 'awake' patients, which is described in the instruction manual: in some studies, the mask was removed when the laryngeal reflexes or swallowing had returned, but before the patient had regained consciousness [4,5,7].…”

“…However, in none of these studies, did they follow the method of removal in 'awake' patients, which is described in the instruction manual: in some studies, the mask was removed when the laryngeal reflexes or swallowing had returned, but before the patient had regained consciousness [4,5,7]. In addition, the patient was placed in the lateral position [6,7]. Furthermore, a bite block was not used in at least one study [6].…”

“…In addition, the patient was placed in the lateral position [6,7]. Furthermore, a bite block was not used in at least one study [6]. Therefore, the incidence of complications during removal of the laryngeal mask using the method described in the manual is not known.…”

“…Removal of the mask after airway reflexes have started to return, but the patient has not regained consciousness, is likely to cause respiratory complications [12]. In addition, a bite block was not used in one study [6], in which biting of the tube of the laryngeal mask occurred in 13 of 50 patients [6]. Such complications could have been prevented by correct use, as described in the manual.…”