Safety and efficacy of laryngeal mask airway ventilation in obese patients with airway stenosis

Abstract

Objective: To assess the efficacy of laryngeal mask airway (LMA) ventilation in obese patients with airway stenosis.

Study design: A retrospective chart review was conducted in an academic practice in a tertiary care center.

Methods: We retrospectively reviewed our experience using LMA ventilation in obese patients with airway stenosis. Lowest intraoperative O₂ saturation and maximum-end tidal carbon dioxide (CO₂ ) levels were recorded. Complications including intubation, unplanned admission, re-admission, postoperative pain, dysphonia, oral trauma, pneumothorax, pneumomediastinum, and tracheostomy were recorded.

Results: Fourteen bronchoscopies with laser incisions and dilation were performed in patients with airway stenosis exclusively using LMA ventilation. Thirteen of 14 procedures were performed on patients who had body mass index (BMI) > 30 kg/m² . Mean BMI was noted to be 38 kg/m² (range 25-54). All patients underwent successful laser incisions and dilation via LMA anesthesia without major or minor adverse events. The mean lowest O₂ saturation level was noted to be 92%; the mean highest CO₂ level was noted to be 56 mm Hg; and no patients required endotracheal intubation.

Conclusion: In this small series of obese patients with airway stenosis, LMA anesthesia was effectively used without major or minor complications.

Level of evidence: 4. Laryngoscope, 127:2582-2584, 2017.

Keywords: Laryngeal stenosis; airway; laryngeal mask airway; tracheal stenosis.