Does anyone (else) use LMAs for endarterectomies?
Works a treat the 3 times of tried it. Got to get the surgeon used to it, as it does give a degree of fullness in the neck.
I had to use an LMA once.
Was doing CEA under cervical plexus block and some sedation, when patient started to obstruct, get hypoxic and confused. I managed to slip him a little propofol, and insert an LMA under the drapes without disturbing the surgical field. 60 seconds later, surgery back under way, and my surgeon amazed that I could intubate so quickly and without having to re-prep and re-drape. 8)
For most longer head and neck work, when the airway is difficult to access, I think the most secure airway possible is the best. ie a ETT. I wouldn't risk anything less.
Yeah, I agree with Geoffrey's post. Have had four hematomas in eight years and without an ETT the results could've been catastrophic.
Quote from: jetproppilot on January 19, 2005, 02:07:36 AM
Have had four hematomas in eight years and without an ETT the results could've been catastrophic.
Sure, but hematomas usually happen in the post-operative period by the time the patient has been extubated. What about for intra-operative use?