The use of a laryngeal mask airway in spontaneously breathing patients.

The Laryngeal Mask Airway (LMA) is a new type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anaesthesia in certain cases. Once the patient is adequately anaesthetised, it can be inserted blindly, without recourse to laryngoscopy or muscle relaxants. Anaesthetists of all grades, given minimum instruction, were able to provide a clinically satisfactory airway in 49 out of 50 spontaneously breathing, anaesthetised patients. The advantages over standard mask anaesthesia are: better airway control, minimal leakage of anaesthetic gases, secure airway during transport to the recovery ward, and it frees the anaesthetist's hands, as no mandibular support is needed. Postoperative problems were minimal and 97.6% of our patients said that they would prefer a similar anaesthetic in future. LMA does not guarantee against the risk of aspiration and it is not recommended for use in patients who may have a full stomach.