FACTORS ASSOCIATED WITH PLACEMENT FAILURE OF SECOND-GENERATION LARYNGEAL MASK AIRWAY: A RETROSPECTIVE CLINICAL STUDY

Authors : Zehra İpek Arslan Aydın, İpek İzgin Avcı, İbrahim Erkut Avcı

Pages : 5-10

Doi:10.53446/actamednicomedia.1486989

View : 59 | Download : 25

Publication Date : 2025-02-28

Article Type : Research Paper

Abstract :Objective: The laryngeal mask airway (LMA) is important for airway management during anesthesia practice. Rarely, when it cannot be placed, it requires alternative interventions. In this study, we aimed to identify factors associated with second-generation LMA placement failure. Methods: Between 2021 and 2023, medical records of consecutive patients who underwent ureteroscopy for urolithiasis under general anesthesia were retrospectively reviewed. Exclusion criteria were: age <18 years and endotracheal intubation as the first preference for airway management. Patients were divided into two groups: (1) those who were successful in LMA placement; and (2) those in whom LMA placement failed. LMA placement failure and associated factors, including body mass index (BMI), gender, mallampati score, thyromental distance, cervical spine mobility, structural status of teeth, American Society of Anesthesiology score (ASA), and history of difficult airway, were evaluated. Results: 188 patients analysed: Male gender (67%), ASA-2 was the majority (56%), and the patients had a mean age of 52.9±14.44 and a BMI of 28.9±5.62 kg/m2. Placement of LMA was successful on initial attempt in 173 (92%); LMA number 4 was most commonly used (57%). Fifteen patients required intubation when the LMA did not settle after three attempts. Comparison of the successful and failed placement groups showed: 14/15 (93.3%) were male (p=0.024). A significant prolongation of anesthesia occurred in patients in whom LMA was not placed (p=0.017). Conclusion: LMA placement failure occurred in 8% of this cohort and most of these patients were male. After LMA placement failure, anesthesia time is significantly prolonged.
Keywords : Laryngeal Mask Airway, difficult, urogenital surgery, adult

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