Document Detail


Oxygen leakage around the laryngeal mask airway during laser treatment of port-wine stains in children.
MedLine Citation:
PMID:  8109765     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The flash-lamp pumped pulsed dye laser is the current treatment of choice for cutaneous port-wine stains. In our practice, most children with these lesions are treated under general anesthesia. At energy levels used clinically, it is possible to ignite hair in the presence of supplemental oxygen; we are aware of four cases in which either the eyebrows or eyelashes were ignited during the administration of general anesthesia via a face mask. The laryngeal mask airway (LMA) recently has become widely available and this device might decrease the risk of fire during treatment of these lesions. We therefore designed this study to examine the extent of oxygen leakage under the mask during clinical cases, and to compare this with the leakage present with the LMA. A total of 20 patients aged 4 mo to 16 yr were studied on 26 separate occasions. During spontaneous ventilation, high concentrations of oxygen leaked around the mask in every case (mean 63% +/- 16%), but in only one case was a concentration more than 21% detected around the LMA (P < 0.001). During controlled ventilation with the LMA, oxygen leaked around the mask in 19% of cases. Use of the LMA markedly decreases the incidence of potential oxygen leakage into the laser field, and is recommended for use, with preservation of spontaneous ventilation, during these cases. We suggest measuring oxygen concentrations at the mouth for laser treatment of facial port-wine stains to confirm that the larynx has been isolated.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R H Epstein; B H Halmi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  78     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-03-24     Completed Date:  1994-03-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  486-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anesthesia, General*
Child
Child, Preschool
Facial Neoplasms / radiotherapy*
Fires*
Hemangioma / radiotherapy*
Humans
Infant
Laryngeal Masks / adverse effects*
Laser Therapy*
Oxygen*
Risk
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

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


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