| Optimal degree of mouth opening for laryngeal mask airway function during oral surgery. | |
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MedLine Citation:
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PMID: 20727637 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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Takuro Sanuki; Shingo Sugioka; Motoko Hirokane; Hiroki Son; Rumiko Uda; Masafumi Akatsuka; Junichiro Kotani |
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Publication Detail:
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Type: Journal Article Date: 2010-08-19 |
Journal Detail:
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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:
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Created Date: 2011-03-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8206428 Medline TA: J Oral Maxillofac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1018-22 Citation Subset: AIM; D; IM |
Copyright Information:
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Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Assistant Professor, Department of Anesthesiology, Osaka Dental University, Osaka, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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