Upper Airway Mucosal Injuries Following the Use of Laryngeal Mask / 대한마취과학회지

The complications following the use of laryngeal mask(LM) are usually mild and cause clinical problems rarely. However, as the use of LM increases, it seems important to know the common injuries, symptoms, and factors relevant to complications from its use. We investigated prospectively the influence of age, sex, height, weight, duration of LM placement, presence of blood tinged on LM and coughing on LM placement, use of anticholinergics, anticholinesterase, and opioid on the mucosal injuries and patient symptoms in 97 healthy adult patients undergoing elective surgery by the indirect laryngoscopy and questionnaire 8~24 hours after surgery. The upper airway symptoms were throat discomfort(22.7%), and sore throat(10.3%). The findings of mucosal injuries were erythema(27%), edema(5%), and petechial hematoma(2%). The mucosal injuries were centered around the pharynx and the epiglottis(63.6% of total mucosal injuries), and 17 of 21 patients who were observed to have mucosal injuries complained upper airway symptoms. These resuts suggest that the pharynx and epiglottis are most vulnerable to injuries and most common sites causing upper airway symptoms from the LM placement. Vocal cord erythema was found in 8.2% of patients, which was seemed to be due to the grates of the LM aperture. The severity of the mucosal injuries was correlated to the severity of upper airway symptoms(P < 0.05, r=0.464). Male sex, presence of blood on LM, and the longer duration of LM placement were associated with a relatively high incidence of mucosal injuries, and the longer duration of LM placement with that of upper airway symptoms(P < 0.05). After above variables were controlled for, presence of blood on LM was a precipitating factor in mucosal injuries and the longer duration of LM placement was precipitating factor in symptoms(P < 0.05). We failed to find a significant correlation of duration of LM placement with the severity of mucosal injuries or symptoms.

Effects of Laryngeal Mask Insertion on Cardiovascular Responses during Cesarean Section / 대한마취과학회지

In 1983, Brain introduced laryngeal mask as a new airway. Laryngeal mask bave many advantages of easy insertion without laryngoscope and muscle relaxants, minimal cardiovascular responses, decreasing damages of larynx and pharynx and also useful in difficult intubation or emergency airway care. We studied cardiovascular responses of parturients and Apgar score of neonates during tracheal intubation(Group I) and laryngeal mask insertion(Group II), After tracheal intubation or insertion of laryngeal mask, blood pressure(systolic, diastolic and mean) and heart rate were measured for 5 minutes at 1 minute interval. The results were as follows: 1) There were significant increase in systolic, diastolic, mean arterial pressure and heart rate in both groups, but degree of increase was less in laryngeal mask group. 2) The Apgar scores of the neonates did not differ significantly, 1 minute Apgar score was up 8 in both group. It is concluded that insertion of laryngeal mask is beneficial to parturients than use of laryngoscope and tracheal intubation to avoid harmful cardiovascular responses in the management of airway during cesarean section.