Optimal degree of mouth opening for laryngeal mask airway function during oral surgery
| Autor: | Junichiro Kotani, Hiroki Son, Rumiko Uda, Masafumi Akatsuka, Shingo Sugioka, Motoko Hirokane, Takuro Sanuki |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Leak Adolescent Oral surgery Oral Surgical Procedures Oropharynx Vocal Cords Epiglottis Laryngeal Masks Young Adult Laryngeal mask airway Capnography Bronchoscopy Sore throat medicine Pressure Tidal Volume Humans Airway Management Tidal volume Optical Fibers Aged Aged 80 and over Mouth business.industry Middle Aged Surgery Mouth opening Otorhinolaryngology Elective Surgical Procedures Anesthesia Breathing Female Oral Surgery medicine.symptom business Airway |
| Zdroj: | Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 69(4) |
| ISSN: | 1531-5053 |
| Popis: | This study was performed to determine the optimal degree of mouth opening in anesthetized patients requiring laryngeal mask airway (LMA) during oral surgery.A single, experienced LMA user inserted the LMA in 15 patients who were scheduled for elective oral surgery. Oropharyngeal leak pressure, intracuff pressure, and fiberoptic assessment of the LMA position were sequentially documented in 5 mouth conditions-opening of 1.4 (neutral position), 2, 3, 4, and 5 cm-and any resulting ventilatory difficulties were recorded.Oropharyngeal leak pressure with the mouth open 4 cm (21.8 ± 3.2 cm H(2)O, P = .025) and 5 cm (27.3 ± 7.2 cm H(2)O, P.001) was significantly higher than in the neutral position (18.1 ± 1.5 cm H(2)O), as was intracuff pressure (neutral position, 60.0 ± 0 cm H(2)O; 4 cm, 72.6 ± 5.1 cm H(2)O [P.001]; and 5 cm, 86.9 ± 14.4 cm H(2)O [P.001]). LMA position, observed by fiberoptic bronchoscopy, was unchanged by mouth opening, being similar in the 5 mouth conditions (P = .999). In addition, ventilation difficulties (abnormal capnograph curves or inadequate tidal volume) occurred in 2 of 15 patients (13%) and 7 of 15 patients (53%) (P.001) with the mouth opening of 4 and 5 cm, respectively.This study showed that a mouth opening over 4 cm led to substantial increases in oropharyngeal leak pressure and intracuff pressure of the LMA, warranting caution, because gastric insufflation, sore throat, and ventilation difficulties may occur. A mouth opening of 3 cm achieves acceptable airway conditions for anesthetized patients requiring LMA. |
| Databáze: | OpenAIRE |
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