máscara laríngea proseal - Sociedad de Anestesiología de Chile

More documents

Recommendations

Info

JOSÉ GUZMÁN O.todas las versiones del tubo laríngeo, cobra, slipa,combitubo, etc. y ningún supraglótico ha mostradoser superior a esta máscara hasta el momento 41-44 .Complicaciones y efectos adversos.La incidencia de ronquera, disfagia, dolor degarganta, disfonía, etc., no difiere con la de otrasmáscaras y es menor que la producida por laintubación orotraqueal 2,5,6 .La máscara laríngea ProSeal produce un muybuen sello glótico, pero en ocasiones - el cuff- en especial cuando está sobre-inflado, puedecomprimir la glotis y obstruir la ventilación, clínica(0,3%) 45 o sub-clínicamente (5%) 46 (Figura 7).Esta máscara es reutilizable (hasta 40 esterilizaciones),y permite la difusión de N 2O, por lo que sedebe tener especial cuidado cuando se utiliza estegas, ya que permea al interior elevando la presióndel cuff, que a menudo puede superar los 100 cm deH 2O 47 . Existen varios reportes de parálisis de cuerdasvocales (normalmente unilateral), y del nerviohipogloso o lingual, siendo el denominador comúnla sobrepresión del cuff, producida principalmentepor la difusión de óxido nitroso 48-49 .La principal medida profiláctica de problemasy complicaciones es una cuidadosa técnica deinserción y el control rutinario de la presión delcuff, que no debe superar los 60 cm de H 2O. Siexiste filtración a presiones bajas de ventilación(menor a 16 cm de H 2O) luego de una aparenteinserción exitosa, lo más probable es que existaun mal posicionamiento de la máscara y no debetratar de corregirse inflando el cuff más allá delo recomendado, quedando la alternativa de unsegundo intento pero esta vez guiada por un bougieo simplemente cambiarse a una intubación.BIBLIOGRAFÍA1. Brain AI, Verghese C, Strube PJ.The LMA ‘ProSeal’ -a laryngealmask with an oesophageal vent. BrJ Anaesth 2000; 84: 650-4.2. Cook TM, Lee G, Nolan JP. TheProSeal TM laryngeal mask airway:a review of the literature. Can JAnesth 2005; 52: 739-60.3. Cook T M, Gibbison B. Analysisof 1000 consecutive uses of theProSeal laryngeal mask airway TMby one anaesthetist at a districtgeneral hospital. Br J Anaesth2007; 99: 436-9.4. Goldman K, Hechtfischer C, MalikA, Kussin A. Use of ProSealLaryngeal Mask Airway in 2114Adult Patients: A ProspectiveStudy. Anesth Analg 2008; 107:1856-61.5. Brimacombe J, Keller C. ThePro-Seal laryngeal mask airway. Arandomized crossover study withthe standard laryngeal mask airwayin paralyzed anesthetized patients.Anesthesiology 2000; 93: 104-9.6. Cook TM, Nolan JP, VergheseC, et al. A randomised crossovercomparison of the ProSeal with theclassic laryngeal mask airway inunparalysed anaesthetised patients.Br J Anaesth 2002; 88: 527-33.7. Natalini G, Franceschetti ME,Pantelidi MT, et al. Comparisonof the standard laryngeal maskairway and the ProSeal laryngealmask airway in obese patients. Br JAnaesth 2003; 90: 323-6.8. Keller C, Brimacombe J, KleinsasserA, Brimacombe L. The laryngealmask airway ProSeal as a temporaryventilatory device in grosslyand morbidly obese patients beforelaryngoscope-guided tracheal intubation.Anesth Analg 2002; 94:737-40.9. Maltby JR, Beriault MT, WatsonNC et al. The LMA-ProSeal isan effective alternative to trachealintubation for laparoscopic cholecystectomy.Can J Anesth 2002; 49:857-62.10. Hohlrieder M, BrimacombeJ, von Goedecke A, C Keller.Postoperative nausea, vomiting,airway morbidity and analgesicrequirements are lower forthe ProSeal laryngeal maskairway than the tracheal tube infemales undergoing breast andgynaecological surgery. Br JAnaesth 2007; 99: 576-80.11. Fabregat-López J, García-RojoB, Cook T M. A case series ofthe use of the ProSeal laryngealmask airway in emergency lowerabdominal surgery. Anaesthesia2008, 63: 967-971.12. Brimacombe J, Keller C. Stabilityof the LMAProSeal® and thestandard laryngeal mask airway indifferent head and neck positions: arandomized crossover study. Eur JAnaesthesiol 2003; 20: 65-9.13. Brimacombe J, Wenzel V, Keller C.The ProSeal laryngeal mask airwayin prone patients: a retrospectiveaudit of 245 patients. AnaesthIntensive Care 2007; 35: 222-25.14. Howarth A, Brimacombe J, KellerC. Gum-elastic bougie-guidedinsertion of the ProSeal laryngealmask airway: a new technique. AnaesthIntens Care 2002; 30: 624-7.15. Brimacombe J, Keller C, JuddDV. Gum elastic bougie-guidedinsertion of the ProSeallaryngeal mask airway is superiorto the digital and introducer tooltechniques. Anesthesiology 2004;100: 25-9.16. Eschertzhuber S, BrimacombeJ, Hohlrieder M, et al. Gumelastic bougie-guided insertionof the ProSeal laryngeal maskairway is superior to the digitaland introducer tool techniques inpatients with simulated difficultlaryngoscopy using a rigid neckcollar. Anesth Analg 2008; 107:1253-6.17. El Beheiry H, Wong J, Nair G.Improved esophageal patency wheninserting the ProSeal TM laryngealmask airway with an Eschmann TMtracheal tube introducer. Can JAnesth 2009. In press.18. Taneja S, Agrawal M, Dali J.S,Agrawal G. Ease of Proseal LaryngealMask Airway insertion andits fibreoptic view after placementusing Gum Elastic Bougie: a comparisonwith conventional techniques.Anaesth Intens Care 2009;37: 435-440.112Rev Chil Anest 2009; 38: 107-113
MÁSCARA LARÍNGEA PROSEAL19. Brimacombe J, Keller C. A modifiedrapid sequence induction usingthe ProSeal laryngeal mask airwayand an Eschmann tracheal tubeintroducer or gum elastic bougie.Anesthesiology 2004; 101: 1251-2.20. McCrirrick A, Ramage DT, PracilioJA. Experience with the laryngealmask airway in two hundred patients.Anaesth Intens Care 1991;19: 256-260.21. López Gil M, Brimacombe J. Laryngealmask airway in pediatricpractice, a prospective study of skillacquisition by anesthesia residents.Anesthesiology 1996; 84: 807-811.22. Brimacombe J. Analysis of 1500laryngeal mask uses by one anaesthetistin adults undergoing routineanaesthesia. Anaesthesia 1996; 51:76-80.23. Kodaka M, Okamoto Y, KoyamaK, Miyao H. Predicted values ofpropofol EC 50and sevoflurane concentrationfor insertion of laryngealmask Classic and ProSeal. Br JAnaesth 2004; 92: 242-5.24. Handa-Tsutsui F, Kodaka M. Propofolconcentration requirementfor laryngeal mask airway insertionwas highest with the ProSeal,next highest with the Fastrach, andlowest with the Classic type, withtarget-controlled infusion. J ClinAnesth 2005; 17: 344-347.25. O’Connor CJ Jr, Stix MS, ValadeDR. Glottic insertion of the ProSealLMA occurs in 6% of cases: a reviewof 627 patients. Can J Anaesth2005; 52: 199-204.26. Brimacombe J, Keller C. Aspirationof gastric contents during use of aProSeal laryngeal mask airwaysecondary to unidentified foldovermalposition. Anesth Analg 2003;97: 1192-4.27. Evans NR, Gardner SV, James MF.ProSeal laryngeal mask protectsagainst aspiration of fluid in thepharynx. Br J Anaesth 2002; 88:584-7.28. Chuan Su, Wen Yang, Chen Lee.Protection against Large-volumeRegurgitated Fluid Aspiration bythe ProSeal Laryngeal MaskAirway. Acta Anaesthesiol Taiwan2008; 46: 34-38.29. Evans NR, Llewellyn RL, GardnerSV, James MF. Aspiration preventedby the Proseal laryngeal maskairway: a case report. Can J Anesth2002; 49: 413-6.30. Borromeo CJ, Canes D, Stix MS,Glick ME. Hiccupping and regurgitationvia the drain tube of theProSeal laryngeal mask (Letter).Anesth Analg 2002; 94: 1042-3.31. Mark DA. Protection from aspirationwith the LMAProseal aftervomiting: a case report. Can J Anaesth2003; 50: 78-80.32. Keller C, Brimacombe J, KleinsasserA, Loekinger A. Does theProSeal laryngeal mask airwayprevent aspiration of regurgitatedfluid? Anesth Analg 2000; 91:1017-20.33. Drolet P. Management of the anticipateddifficult airway-a systematicapproach: Continuing ProfessionalDevelopment. Can J Anaesth 2009;56: 683-701.34. Baxter S, Brooks A, Cook TM. Useof the ProSeal LMA for airwaymanagement after failed rapidsequence induction. Anaesthesia2003; 58: 1132-3.35. Cook TM, Brooks TS, Van derWesthuizen J, Clarke M. TheProSeal TM LMA is a useful rescuedevice during failed rapid sequenceintubation: two additional cases.Can J Anaesth 2005; 52: 630-3.36. Awan R, Nolan JP, Cook TM. Useof the ProSeal LMA for airwaymaintenance during emergencyCaesarean section after failed intubation.Br J Anaesth 2004; 92:144-6.37. Keller C, Brimacombe J, LirkP, Puhringer F. Failed obstetrictracheal intubation and postoperativerespiratory support with theProSeal laryngeal mask airway.Anesth Analg 2004; 98: 1467-70.38. Grier G, Bredmose P, Davies G,Lockey D. Introduction and use ofthe ProSeal laryngeal mask airwayas a rescue device in a pre-hospitaltrauma anaesthesia algorithm. Resuscitation2009; 80: 138-41.39. Cook TM, Silsby J, Simpson TP.Airway rescue in acute upper airwayobstruction using a ProSeal TMLaryngeal mask airway and anAintree Catheter TM - a review of theProSeal TM Laryngeal mask airwayin the management of the difficultairway. Anaesthesia 2005; 60:1129-36.40. Cook TM, Seller C, Gupta K etal. Non-conventional uses of theAintree Intubating catheter in managementof the difficult airway:fourteen reports. Anaesthesia 2007;62: 169-74.41. Brimacombe J, Keller C, BrimacombeL. A comparison of the laryngealmask airway ProSeal andlaryngeal tube airway in paralyzedanesthetized adult patients undergoingpressure controlled ventilation.Anesth Analg 2002; 95: 770-6.42. Gaitini LA, Vaida SJ, Somri M, etal. A randomized controlled trialcomparing the ProSeal laryngealmask airway with the laryngealtube suction in mechanically ventilatedpatients. Anesthesiology2004; 101: 316-20.43. Bein B, Carstensen S, Gleim M,Claus L. A comparison of theproseal laryngeal mask airway TM ,the laryngeal tube S® and theoesophageal-tracheal combitube TMduring routine surgical procedures.Eu J Anaesthiol 2005; 22: 341-346.44. Kikuchi T, Kamiya,Y, OhtsukaT, et al. Randomized ProspectiveStudy Comparing the LaryngealTube Suction II with the ProSealLaryngeal Mask Airway in Anesthetizedand Paralyzed Patients.Anesthesiology 2008; 109: 54-60.45. Brimacombe J, Richardson C,Keller C, Donald S. Mechanicalclosure of the vocal cords with thelaryngeal mask airway ProSeal.Br J Anaesth 2002; 88: 296-7.46. Stix MS, O’Connor CJ Jr. Maximumminute ventilation test for theProSeal laryngeal mask airway.Anesth Analg 2002; 95: 1782-7.47. Tekin M, Kati I, Tomak Y, Yuca K.Comparison of the effects of roomair and N 2O + O 2used for ProSealLMA cuff inflation on cuff pressureand oropharyngeal structure. JAnesth 2008; 22: 467-70.48. Trumplemann P, Cook TM. Unilateralhypoglossal nerve injury followinguse of a ProSeal laryngealmask. Anaesthesia 2005; 60: 101-2.49. Bruce I A, Ellis R, Kay NJ. Nerveinjury and the laryngeal mask airway.The Journal of Laryngology &Otology 2004; 118: 899-901.Correspondencia:Dr. José Guzmán O.E-mail: guzman.jose133@gmail.comRev Chil Anest 2009; 38: 107-113113
Page 2: JOSÉ GUZMÁN O.N° máscaralaringe
Page 5: MÁSCARA LARÍNGEA PROSEALFigura 7.

máscara laríngea proseal - Sociedad de Anestesiología de Chile

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?