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Korean Journal of Anesthesiology 1998;35(3):492-497.
DOI: https://doi.org/10.4097/kjae.1998.35.3.492   
Clinical Investigation of Laryngeal Mask Airway Use in Geriatric Patients.
Chong Wha Baek, Yu Mee Lee, Hong Seuk Yang
1Department of Anesthesiology, College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Korea.
2Department of Anesthesiology, Asan Medical Center, Seoul, Korea.
The laryngeal mask airway (LMA) has many advantages including easy insertion, less trauma, minimal cardiovascular changes. And the elderly have many problems such as poor dentition, limited cervical extension and age related cardiovascular changes, so endotracheal intubation in geriatric patient is sometimes difficult and harzardous. This clinical study was designed to investigate availability and problems of LMA insertion in geriatric patients.
60 geriatric patients undergoing elective surgery were induced with intravenous injection of pentothal sodium or propofol, vecuronium or atracurium and inhalation of O2, N2O, enflurane or isoflurane. After deep anethesia and full muscle relaxation LMA was inserted and cuff was inflated. When blind insertion was failed, laryngoscope was used. Anesthesia was maintained with inhalation of O2, N2O, enflurane or isoflurane under positive pressure ventilation. Thereafter, we observed peak inspiratory pressure and any incident including gas leakage, stomach distension, regurgitation of stomach content intraoperatively and then any complication postoperatively.
LMA placement was successful in 98.8%, but LMA insertion in geriatric patient had some difficulty because patient's tongue slided down with LMA due to oropharyngeal dryness, teeth loss. Intraoperatively LMA was well maintained under positive pressure ventilation. There was no critical incident associated with LMA use.
LMA is safe and may have a useful role in the anesthetic management of geriatric patients who have many problems such as poor dentition, limited cervical extension and age related cardiovascular changes.
Key Words: Anesthesia: geriatric; Equipment: laryngeal mask airway


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