Disadvantages of the Laryngeal Mask

The biggest problem with laryngeal anesthesia is that ventilation with a laryngeal mask is not a safe airway. This means that despite optimal positioning and blocking of the cuff, the mask can easily slip and endanger the oxygen supply. Especially during operations where the patient has to be moved or repositioned during surgery, there is a risk of slipping.

In most cases, the mask can be corrected by light measures, but this must be done during the operation under difficult conditions and is no longer possible in rare cases. If this should occur, emergency endotracheal intubation is necessary, which is associated with an increased risk under difficult conditions. Also, the laryngeal mask does not provide protection against aspiration. If stomach contents or gastric acid do reflux into the neck, it can pass through the laryngeal mask and enter the lungs via the trachea. This can lead to life-threatening pneumonia and damage.

Risks/Complications of the Laryngeal Mask

In comparison to endotracheal intubation, anesthesia with laryngeal mask is associated with some risks. Since the laryngeal mask is located in front of the larynx and not in the trachea behind the vocal folds, there is always the risk of slipping. Often there is only a slight change in position, which only causes a leak in the oxygen supply.

However, this leak can usually be easily closed again by making a minimal correction to the mask.However, if the mask is completely displaced or, in the worst case, the mask is pulled out, emergency intubation using an endotracheal tube is usually necessary. Movement of the mask can cause serious injury and swelling in the throat area, which can ultimately result in a life-threatening airway. Another severe complication of laryngeal anesthesia is aspiration. If gastric acid refluxes into the esophagus, it can flow past the laryngeal mask and enter the trachea and then the lungs. In the lungs, stomach acid can cause severe damage and life-threatening pneumonia.