Successful Anesthetic Management of Morbidly Obese Patients During Electroconvulsive Therapy With the ProSeal Laryngeal Mask Airway in a Head-up Position

Laryngeal Mask (i-gelR) Partially Broken by Biting Caused by Electrical Stimulation During Electroconvulsive Therapy

“…As a result, an additional bite block is generally accepted as unnecessary when using the i-gel R for general anesthesia 5 . A laryngeal mask is not always used for airway management during ECT but may be effective to maintain airway patency in patients with morbid obesity 1 or cervical spine disease 2 . In addition, hyperventilation is needed to allow adequate seizure duration during ECT.…”

“…However, manual mask ventilation is difficult in obese patients. Koyama et al 1 reported successful airway management using a normal laryngeal mask during ECT for 2 obese patients. Kadoi et al 2 reported the efficacy of using a laryngeal mask (i-gel R ; Intersurgical; Nihon Medical Co, Osaka, Japan) for patients with cervical spondylosis to protect against further cervical spine cord injury.…”

Microlaryngeal surgery in severely obese elite vocal performers

“…This position is recommended as a good choice for tracheal intubation in such cases. 3 , 4 , 5 However, due to the ramp position, the microlaryngeal surgery, usually performed sitting in a chair, was performed standing (Figure 3 ). When performed in the standing position, the angle of entry of the scalpel and forceps to the horizontal direction is slightly steeper.…”

“…The ramp position is selected for intubation of obese patients, in which a towel or soft cloth pillow is placed from the shoulder to the neck of the obese patient to maintain a semi‐sitting position (Figure 2). This position is recommended as a good choice for tracheal intubation in such cases 3‐5 . However, due to the ramp position, the microlaryngeal surgery, usually performed sitting in a chair, was performed standing (Figure 3).…”