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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 1999 July-August;65(7-8):561-9

language: Italian

Use of the laryngeal mask airway in the management of airways and difficult intubation in pediatrics

Orfei P. 1, Frandina G. 2, Patrizio A. 1, Bigetti E. 1, Nicolucci S. 1, Romualdi R. 1, Galassi A. 1, Pinto G. 1

1 Università degli Studi «La Sapienza» - Roma, Istituto di Anestesiologia e Rianimazione;
2 Università degli Studi «La Sapienza» - Roma, Istituto di Clinica Pediatrica


LMA was introduced in clinical practice by Arthur Brain in 1983 as a valuable substitute of tracheal tube in adult who underwent general anaesthesia; since then its applications have been extensively studied. LMA is a relatively new non-invasive ventilatory device which has allowed a radical change in the management of modern general anaesthesia. In this study, the application of LMA is assessed during induction and maintenance of general anaesthesia in children affected by severe facial deformities that could render the placement of the tracheal tube difficult. Three patients were affected by complex malformative syndromes involving the maxillo-facial skeleton and one patient presented a massive teratoma, originating from the orbit. In all these cases, LMA provided a patent airway and a satisfactory ventilation during both induction and the repeated attempts of inserting the tracheal tube; in one case, since the oro-tracheal intubation failed, LMA has proved to be as effective as the tracheal tube during the maintenance of general anaesthesia. There-fore, LMA is recommended as an essential ventilatory device in the hands of paediatric anaesthesiologists.

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