| Popis: |
We have adopted a way of positioning and securing the flexible laryngeal mask that maximises the surgical access and minimises the risk of dislodging it. We have used this technique successfully in over 100 day case operations. Once inserted, the LMA should be positioned in the mid-line facing upwards over the nose. The catheter mount should be connected to the LMA before the filter is connected to prevent the filter pressing on the forehead. The LMA is then connected to the anaesthetic circuit and secured to the forehead and nose. Before securing the tube with tape, we advise padding to protect the nose and forehead from pressure at any points of contact (Fig. 1). Once secured in this way, the LMA is protected beneath the head-towels and a full range of mandibular movements are possible without restriction and without the risk of dislodging the LMA. Access to the surgical field is substantially increased, insertion of the mouth-prop is not interfered with, positioning of the tongue-retractor is made easier and it is not necessary to move the LMA when operating on both sides at the back of the mouth. |
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