[The usefulness of the laryngeal mask in ambulatory anesthesia. An evaluation of 200 cases of ambulatory anesthesia].

We studied the value of Brain's laryngeal mask on 200 patients undergoing ambulatory operations under general anaesthesia using propofol and alfentanil. Continuous registration of maximal airway pressure and pulse oximetry were carried out. The operations were performed mainly in the following four specialities: urology, general surgery, gynaecology, and ophthalmology. The mean operation time was 39 min (6-82 min). All patients belonged to ASA groups I-III. No patient was premedicated. We encountered no difficulties in introducing the mask using the technique described by Brain except in one 6-year-old boy with hypertrophic tonsils in whom it was impossible. Insufficient sealing of the trachea occurred in a 29-year-old woman with thyroid hypertrophy. In most patients (70%) the oxygen saturation (spO2) could be maintained above 95%; only 6 (2%) showed an spO2 value of less than 90%. Peak inspiratory pressures--a measure of tight fitting of the mask--are shown in Table 2. Laryngospasm occurred in 2 children who had inhalation inductions with halothane. This complication was never seen after induction with propofol. The most important positive finding was that relaxant drugs became largely unnecessary after we started working with the mask, which reduced postoperative recovery time as well as costs. CONCLUSION. We consider the laryngeal mask to be not only an important new technique, but in combination with propofol and alfentanil the method of choice for ambulatory anaesthesia in day-case surgery.