Why use the laryngeal mask airway

Laryngeal mask airway is usually abbreviated as LMA, It has become a very important tool in modern anesthesia and emergency medicine, and has many unique advantages in airway management.

1. Easy and quick operation, able to quickly establish effective ventilation.
Compared with endotracheal intubation, LMA insertion technique is relatively simple and requires less technical skills from the operator. It can be successfully inserted without the use of a laryngoscope or visualization device (such as a video laryngoscope), and is more likely to succeed in emergency situations or in the hands of inexperienced personnel.It can be placed quickly and can quickly establish effective ventilation, which is a key life-saving technology, especially in emergency situations where intubation and oxygenation are not possible.

2. Less physiological interference: more stable hemodynamics.
Hemodynamic stability: The stimulation to the throat during LMA placement is much less than that of endotracheal intubation, so the cardiovascular response (such as increased heart rate and blood pressure) is usually much milder, especially suitable for patients with unstable cardiovascular function.

3. Low risk of injury.
It is not necessary to enter the trachea through the glottis, which avoids direct damage to the vocal cords, larynx, and tracheal mucosa (such as vocal cord injury and arytenoid cartilage dislocation) that may be caused by tracheal intubation. It reduces the risk of damage to teeth and oral soft tissues (especially in difficult airways or unskilled operations).

4. Retain a certain degree of spontaneous breathing ability.
Most LMA models are designed to allow patients to retain spontaneous breathing during light anesthesia or recovery while providing assisted ventilation. This is very beneficial for short surgeries, outpatient surgeries, and situations that require rapid awakening.

5. Critical in difficult airway management.
LMA is one of the core tools for dealing with expected and unexpected difficult airways. When tracheal intubation fails, LMA can often be successfully inserted and provide effective ventilation, solve oxygenation problems, and buy time for subsequent establishment of a definitive airway. It can be used as a channel to guide tracheal intubation.

6. Suitable for short and outpatient surgeries.
For short surgeries that do not require deep muscle relaxation, LMA is an ideal choice. Patients wake up faster and more smoothly, and the incidence of complications such as postoperative throat pain and hoarseness is usually lower than that of endotracheal intubation, which is conducive to the rapid turnover and discharge of outpatients. There are fewer postoperative complications and faster recovery.

7. Low muscle relaxation requirement.
Laryngeal mask airway placement usually does not require as deep muscle relaxation as endotracheal intubation. It is suitable for light anesthesia.

8. Lower airway resistance.
Compared with endotracheal tubes, laryngeal mask airways (especially large-caliber models) generally have lower airway resistance and allow for smoother ventilation.

Of course, laryngeal mask airway also has its limitations and contraindications and is not suitable for all situations:Of course, LMA also has its limitations and contraindications and is not suitable for all situations:

•  Risk of aspiration: LMA cannot provide a completely reliable airway seal like an endotracheal tube, nor can it effectively prevent the reflux of gastric contents from being aspirated into the lungs. Therefore, it is contraindicated for patients with a full stomach, high risk of reflux, increased intra-abdominal pressure, gastrointestinal obstruction, not fasting, and prolonged surgery.

•  Airway sealing: In patients who require high airway pressure ventilation (such as severe obesity, poor lung compliance, and laparoscopic pneumoperitoneum), LMA may not provide adequate airway sealing, resulting in air leakage.

•  Laryngeal lesions: Pathological changes in the larynx (such as tumors, infections, deformities) may affect the placement or function of the LMA.

•  Limited mouth opening: Severe limited mouth opening may affect LMA insertion.

The emergence of laryngeal mask has greatly enriched the means of airway management and improved the safety and efficiency of airway management, especially in certain specific scenarios (such as difficult airway and short surgery). However, it needs to be carefully selected according to the specific situation of the patient and the requirements of the operation, and its limitations (mainly the risk of aspiration) should be fully recognized.