Paediatric anaesthesia
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Hyperinflation of the laryngeal mask airway (LMA) cuff is known to be a risk factor for airway morbidity and increased leakage around the LMA. While the manufacturers' recommendation is to inflate the cuff with the maximum recommended volumes and/or to adjust the cuff pressure to <60 cmH2O, cuff pressures below 40 cmH2O have been shown to be associated with a minimal rate of sore throat and minimal leakage. However, it remains to be determined whether inflation or deflation is needed to achieve favorable pressures. Therefore, we assessed the need for cuff-volume adjustment following insertion of the LMA unchanged straight from the sterile packaging in a prospective audit. ⋯ This study demonstrates that LMAs, particularly when using small-sized LMAs or LMAs with a more rigid PVC surface, need to be deflated following insertion of the device rather than inflated to avoid cuff hyperinflation. Hence, cuff pressures should be measured routinely using a manometer to minimize potential pressure-related airway complications.
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Paediatric anaesthesia · Sep 2009
Letter Clinical TrialOur experience of Dyloject (intravenous diclofenac) in children.