Page 45 - CASA Bulletin of Anesthesiology 2022; 9(2) (5)

Vol. 9, No 2, 2022

Table 2. Summary of Non-Standard Uses of the Laryngeal Mask Airway (LMA)

Non-standard use Concerns Conclusions

Mechanical ventilation Gastric insufflation, Adequate ventilation can be achieved with various ventilator
compared to spontaneous aspiration with high modes
ventilation inspiratory pressures Minimize inspiratory pressures to decrease risk of gastric

Inability to self-regulate aspiration

anesthesia depth
Use of muscle relaxant Facilitate mechanical May benefit LMA insertion and surgeries

ventilation

Laparoscopic surgery Aspiration risk with Likely acceptable in properly fasted patients with second-

insufflated abdomen generation devices

Obese patients Poor pulmonary compliance Acceptable for certain degrees of obese patients, further
Ventilation difficulty study warranted prior to recommendation for routine use in

morbid obesity
Successful as a temporary rescue device

Table 3. Absolute and Relative Contraindications to LMA 8, 9, 13, 14

Absolute Contraindications Relative Contraindications

Trauma Major abdominal surgery
Non-fasted patients Pregnancy >14 weeks
Bowel obstruction Prone position
Emergency surgery Airway surgery
Delayed gastric emptying Laparoscopic surgery

Obesity, BMI >30
Decreased lung compliance with PIP >20 cm H 2O
Altered mental status

BMI = body mass index; LMA = laryngeal mask airway; PIP = peak inspiratory pressure

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