Document Detail


Optimal degree of mouth opening for laryngeal mask airway function during oral surgery.
MedLine Citation:
PMID:  20727637     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: This study was performed to determine the optimal degree of mouth opening in anesthetized patients requiring laryngeal mask airway (LMA) during oral surgery.
PATIENTS AND METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
Authors:
Takuro Sanuki; Shingo Sugioka; Motoko Hirokane; Hiroki Son; Rumiko Uda; Masafumi Akatsuka; Junichiro Kotani
Related Documents :
8322567 - Endotracheal tube versus face mask with and without continuous positive airway pressure...
11405527 - Proportional positive airway pressure: a new concept to treat obstructive sleep apnoea.
24618357 - Penile reconstruction with dermal template and vacuum therapy in severe skin and soft t...
11681657 - Respiratory deposition patterns of salbutamol pmdi with cfc and hfa-134a formulations i...
12081987 - Omapatrilat reduces pulse pressure and proximal aortic stiffness in patients with systo...
20428007 - Fluid assessment and management in the emergency department.
Publication Detail:
Type:  Journal Article     Date:  2010-08-19
Journal Detail:
Title:  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons     Volume:  69     ISSN:  1531-5053     ISO Abbreviation:  J. Oral Maxillofac. Surg.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8206428     Medline TA:  J Oral Maxillofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1018-22     Citation Subset:  AIM; D; IM    
Copyright Information:
Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Assistant Professor, Department of Anesthesiology, Osaka Dental University, Osaka, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Salmonella-infected submandibular gland cyst: case report and review of the literature.
Next Document:  Unilateral Cheek Swelling in an Infant: Case Report of an Unusual Presentation of Internal Bleeding ...