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Laryngeal mask indications and the advantages and disadvantages of intubation
1。 Indications of the laryngeal mask: (1) need airway protection and patients of endotracheal intubation. (2) the need to quickly control the airway, especially in the rapid induction period, and intubation are in trouble again. (3) only for the use of the trained anesthesiologists, subject to the consent of the patient before use. (4) facial or particularly useful in patients with cervical spondylosis. (5) outpatient surgery patients with general anesthesia. 6. Emergency rescue of the airway. All landowners difficult intubation. General anesthesia was unstable cervical spondylosis. Pet-name ruby when tracheal intubation is difficult, risky or is not successful, can be used as emergency channel and optical fiber pipe. Attending awake or asleep patients bronchoscopy are available, and critically ill patients with MRI, CT examination and interventional treatment of respiratory tract management.
2。 Contraindications: of the laryngeal mask (1) not fasting patients. (2) morbid obese patients with obstructive lung disease or abnormal sexual oropharyngeal lesions. (3) mouth degrees by laryngeal mask is difficult.
3。 Laryngeal mask advantages: (1) easy to use, fast, airway maintenance easier. (2) without the laryngoscope, compared with endotracheal intubation, novice researchers placed the difficulty of the LMA is small, high success rate. (3) for long time operation without muscle relaxant, LMA replaced the role of the mask. (4) establish the airways to independent ventilation and ventilation control. 5. The location of the LMA even if not very ideal, also can maintain airway patency. 6. Avoid endotracheal mucosa damage. All landowners also tolerated under light anesthesia, tolerance LMA than necessary dose of anesthesia endotracheal tube and reduced. End of anesthesia induction and convalescence hemodynamic stability, reduces the degree of elevated intraocular pressure tube, cough reduce anesthesia convalescence and oxygen saturation, adult incidence of postoperative sore throat is also reduced.
4。 Laryngeal mask shortcomings: (1) the sealing effect is bad, high incidence of flatulence, IPPV will cause flatulence. (2) the LMA esophageal reflux, more easily than mask for not fasting patients cannot completely prevent aspiration. (3) the standard laryngeal mask should not be made strong positive pressure ventilation. (4) oral secretions increase, application of atropine drugs can reduce discharge.
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