Laryngeal Mask Ventilation During Lumbar Spine Neurosurgery in Knee-Chest Position is Feasible.

Hurtado, Paola; FÃ bregas, Neus; Forero, Carolina; Tercero, Javier; Carrero, Enrique; de Riva, Nicolas; Gracia, Isabel; Lopez, Anna M; Valero, Ricard

BACKGROUND This study describes our experience with laryngeal mask (LM) inserted after anesthetic induction in patients already in knee-chest position for lumbar neurosurgery. METHODS Airway management (need for LM repositioning, orotracheal intubation because of failed LM insertion), anticipated difficult airway, and airway complications were registered. Statistics were compared between groups with the t test or the χ test, as appropriate. RESULTS A total of 358 cases were reviewed from 2008 to 2013. Tracheal intubation was performed in 108 patients and LM was chosen for 250 patients (69.8%). Intubated patients had a higher mean age and rate of anticipated difficult airway; duration of surgery was longer (P<0.001, all comparisons). LM insertion and anesthetic induction proved effective in 97.2% of the LM-ventilated patients; 7 patients (2.8%) were intubated because of persistent leakage. Incidences with airway management were resolved without compromising patient safety. CONCLUSION LM airway management during lumbar neurosurgery in knee-chest position is feasible for selected patients when the anesthetist is experienced.