Laryngeal mask airway
15
MENTIONS
8
EPISODES
7
PODCASTS
Search complete. 15 mentions across 8 episodes found for "Laryngeal mask airway".
Sep 28, 2026
Blake ForkeyHOST
My plan is a popliteal sciatic nerve block combined with a saphenous nerve block, often called a pop-saph.
Blake ForkeyHOST
I would proceed with general anesthesia afterwards with an LMA for reliable surgical conditions.
Blake ForkeyHOST
Although these blocks can provide surgical anesthesia, incomplete or patchy coverage can occur, and they may not adequately cover tourniquet discomfort or all the surgical stimulation.
Blake ForkeyHOST
The blocks will primarily provide post-operative analgesia and reduce intraoperative anesthetic and opioid requirements.
RaniGUEST
Is this airway difficult or not? And then, you know, usually we kind of ran some bedside tests like man and patty, thyroid, mental distance, and then we kind of placed our patients into one of two buckets.
RaniGUEST
If they were easy, we decided we'll do like a standard or a routine approach, which usually involves securing the airway with an LMA or tube after induction anesthesia.
RaniGUEST
Or if it was difficult, sometimes we thought about things really, really hard, and we just did our normal approach anyway.
RaniGUEST
Or sometimes we worried about it, created some anxiety, kind of asked for more equipment, or decided to do kind of the extreme, which is the awake kind of intubation, so securing the airway after, before induction of anesthesia.
RaniGUEST
Like Edelman in 2019 did a review on anesthesia.
RaniGUEST
They found that in the English literature, there was about 11 different algorithms or difficult airway algorithms, and each had their own different definition.
RaniGUEST
And difficulty was defined against kind of your oxygenation methods, so essentially technical difficulties with your face microventilation, with putting LMA down or intubation or frontal neck access, difficulty with extubation, number of attempts, the operative experience, the clinical context, and also the complications that you can cause with your airway management.
RaniGUEST
So it really meant that a patient can be difficult on one guideline, but really essentially unremarkable on another guideline.
speaker_7HOST
But now consider tumor surgery, which presents a completely different metabolic and anatomical challenge.
speaker_7HOST
With extensive head and neck tumors, you cannot use supraglottic airway devices like a laryngeal mask airway or LMA.
speaker_6HOST
Because LMAs sit above the vocal cords.
speaker_6HOST
They don't secure the trachea.
speaker_7HOST
Right.
speaker_7HOST
In a surgery where you're resecting tissue and there's a high risk of blood pooling, an LMA leaves the patient entirely vulnerable to aspiration.
speaker_7HOST
Secure cuffed endotracheal intubation is absolutely mandatory.
speaker_6HOST
But there's also a systemic issue with tumor patients.
Tym KajsturaGUEST
Or C, a hysteroscopy under general anesthesia with laryngeal mask airway.
Jed WolpawHOST
So as you said up front, it's only required when you have a closed-loop system, something that is going to get you actually accurate end-tidal monitoring.
Jed WolpawHOST
And so that's going to be either an endotracheal tumor or an LMA.
Jed WolpawHOST
In this case, the answer is going to be C because that case has an LMA in place.
Tym KajsturaGUEST
Correct.
Tym KajsturaGUEST
And I think you could come up with some absolutely wacky situation where A and B could be an ICU patient that does have some definitive airway in place already where you would need to monitor that.
7 MINS LATER
Tym KajsturaGUEST
You should assess the airway before you induce.
Tym KajsturaGUEST
And if assessment is bad enough, you should do it awake or not do it.
DavidGUEST
Now, general anesthesia doesn't necessarily mean you had an airway device.
DavidGUEST
It doesn't necessarily mean you had a general endotracheal tube in or an LMA or some kind of assistive device.
DavidGUEST
What it means is that there's probably a time during a procedure where you were not able to maintain your own airway, or you were not able to respond to painful stimulus.
DavidGUEST
And that's where you get into what we consider a general anesthetic.
PaulHOST
We can do adequate CPR of 30 compressions to two breaths, defibrillate and monitor end-tidal CO2 using a BVM with an oral airway in place.
PaulHOST
Once an advanced airway such as an endotracheal tube, LMA, or esophageal tube is placed, we'll change to constant uninterrupted chest compressions and give one breath every six seconds to deliver approximately 10 breaths per minute.
PaulHOST
It's common at some institutions to use an oral airway as a bite block to protect the tube from occluding should the patient bite down.
PaulHOST
In these cases, the OPA is being used as a bite block and not as an airway.
PaulHOST
As we move down the cardiac arrest algorithm, after we've defibrillated a patient in a shockable rhythm, established an IV, and given the first dose of epi, we'll consider insertion of an advanced airway.
PaulHOST
After the patient is intubated by an experienced provider or another advanced airway, such as an LMA or laryngeal tube airway is placed, we'll change from cycles of two breaths after every thirty compressions and begin delivering a single breath with one hundred percent O2 once every six seconds without pausing compressions.
PaulHOST
We'll still deliver approximately ten breaths per minute with one hundred percent O2 to correct hypoxia while increasing our chest compression fraction by eliminating the pause in compressions to deliver breaths.
PaulHOST
I cover advanced airways and other tips to maintain a CCF above eighty percent in other episodes.