[The laryngeal mask--news in orthopedic anesthesia]

The laryngeal mask airway (LMA) was first used at the Department of Orthopedics, School of Medicine, University of Zagreb on May 8, 1991. Two hundred and three patients were undergoing elective orthopedic surgery during the first year of the LMA use. A size-3 mask was used for women and children weighing over 25 kg (55 lbs) and a size-4 mask for men. Research has been undertaken in 12 patients aged between 30-73 years scheduled for total hip replacement. Blood pressure, heart rate and hemoglobin oxygen saturation were continuously monitored with a noninvasive method. No signs of cardiovascular disorders were noticed 1-min before and 3-min after insertion. Only 2 (16.6%) patients, who suffered no complications, had ventilating pressure higher than 20 cm H2O. The LMA proved to be very useful in anesthesia where endotracheal intubation was difficult or almost impossible. Of 12 examinees, 3 with severe rheumatoid arthritis and 2 with ankylosing spondylitis were successfully anesthetized with the LMA. Awakening from anesthesia was very pleasant. There were no serious complications in terms of laryngo- or bronchospasm, aspiration or insufflation of the stomach. The LMA has been found to be very helpful in solving problems of anesthesia in orthopedic patients. A set of laryngeal mask airways should be an integral part of every anesthetic equipment.