lma, ophthalmic surgery
S Verma. Novel Technique To Modify The Nonfunctional Valve Of LMA's Pilot. The Internet Journal of Anesthesiology. 2006 Volume 14 Number 1.
We report a novel technique to modify the nonfunctional valve of LMA's pilot supposed to be used for an ASA-1 female patient for ophthalmic surgery.
LMAs are nowadays used for ophthalmic procedures1, lower limb procedures under general anaesthesia as well as in pediatric patients. We managed our patient with a novel technique after replacing a nonfunctional valve of the pilot balloon of an LMA with a used endotracheal tube pilot.
An ASA grade 1, 15 year old female patient was posted for squint surgery of her right eye under general anaesthesia. The patient was planned for an LMA to secure her airway as the length of operation was of 30 minutes. After routine checkup of all the instruments, drugs and monitors, it was noticed that the 3 LMA pilot's valve was not working as no air is going into the cuff. To our surprise on that day only one LMA of #3 was in working condition and we had informed our patient that no tube will be placed inside the trachea so we started searching something that can act as valve of pilot balloon. Then we thought of changing the pilot of LMA with the used endotracheal tube of size 6.5 (as shown in the picture). The idea worked and we were able to inflate the cuff of the LMA and the operation went uneventful. After operation when we crosscheck with pilot of different size endotracheal tube, to our surprise it fit to all.
LMAs arenowadays an essential part of anesthesia procedures since its innovation. Further it is a routine protocol to check all the instruments prior to initiating anaesthesia and one should keep in mind that instruments are bound to give trouble. So one has to be prepared from all means either keeping an extra set of the instrument or revert to an innovating alternative technique.
Dr.Sanjay Verma Assistant Professor F-11, Ansari Nagar, (West) AIIMS New Delhi-110029 Email- firstname.lastname@example.org