9.9
Supraglottic Airways
- Indications
- Extraoral procedures
- Short cases
- Intraoral procedure if flexible stalk is used
- Emergency airway
- Contraindications
- Poor mouth opening
- Pharyngeal pathology
- Pharyngeal obstruction
- ↑ Risk of aspiration
- ↓ Pulmonary compliance
- Morbid obesity
- Hypoventilation due to inability to generate larger inspiratory pressures
- Complications [11, 12]
- Easily dislodged or displaced especially with head and neck manipulation
- Distal tip can curl up on itself and reduce ventilation efficacy
- Nerve damage
- Recurrent laryngeal n.
- Trigeminal n.
- Hypoglossal n.
- Abrasion and bleeding of pharyngeal tissues
- Gastric insufflation
- Especially at ventilation pressures >20 cm H2O
- ↑ Risk of vomiting and aspiration
- Easily dislodged or displaced especially with head and neck manipulation
Face Mask Ventilation
- Typically, not an option for longer, more involved oral surgical procedures
- May be a viable option for short, uncomplicated intraoral procedures (extraction of pediatric teeth) if surgery and anesthesia take turns with the airway or for shorter procedures outside of the oral cavity
- Head strap and prongs on face mask will aid in placement and retention
Laryngeal Mask Airway (Figure 9.13)
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