What is laryngeal anesthesia?
Laryngeal Mask Anaesthesia is a normal general anaesthesia, in which endotracheal intubation is dispensed with and a laryngeal mask or laryngeal mask is used instead. Unlike a tube, which is often used to secure the airways during anesthesia, the so-called laryngeal mask is not inserted into the trachea behind the vocal chords, but remains in the pharynx in front of the larynx, where it is inflated and secures ventilation.
Indication
In most cases, the laryngeal mask offers an alternative to classical endotracheal intubation to ensure ventilation during general anesthesia. However, there are also a number of contraindications that prohibit the use of the Laryngeal Mask. For all operations in the face, mouth and ear, nose and throat area, airway protection must be provided by endotracheal intubation, since a laryngeal mask can easily slip and thus endanger ventilation due to its proximity to the surgical site during movements and traction in the throat.
The laryngeal mask can also not be used in patients who are not fasting or pregnant women. In this group of patients there is always the risk of backflow of stomach contents into the esophagus and thus the risk of carry-over into the trachea. Since the Laryngeal Mask, unlike the tube, does not seal the trachea securely, it is clearly contraindicated in this case.
For the same reason, endotracheal intubation is also indicated in patients suffering from heartburn or frequent belching. The Laryngeal Mask is also not suitable for complex operations over several hours. In this case the tube also offers more safety for ventilation without complications. However, for short operations on patients with no previous diseases of the stomach or pharynx, the Laryngeal Mask is a gentle and safe alternative to endotracheal intubation.
Advantages of a Laryngeal Mask
Ventilation using a laryngeal mask offers many advantages during anesthesia. For one thing, the mask is easier to insert than the tube, and no other aids are required to insert the mask, such as a laryngoscope with a tube. This always brings with it the risk of injury to the surrounding tissue.
Also, during an anaesthesia with a laryngeal mask, a muscle-relaxing medication can often be dispensed with and generally less anaesthetics are used. This greatly shortens the wake-up phase after surgery and is often described by patients as a gentle wake-up. Another advantage of the laryngeal mask during the wake-up phase after anesthesia is the reduced irritation of the airways.
Patients are less likely to have a cough when waking up and start breathing more relaxed and spontaneously again. Many patients also find the Laryngeal Mask more comfortable than a tube, since the vocal folds do not have to be passed and therefore no irritation can occur here. Sore throat therefore occurs much less frequently after laryngeal mask anaesthesia and hoarseness almost never.
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