The laryngeal mask airway for general anesthesia: the case for its use

Abstract

About 6 years ago, I began performing general anesthesia in the office because of restrictions in patient access to my local hospital brought about by managed care. We selected ASA I and II patients ranging in age from 4 to about 60. For the first several years, we used oral endotracheal (ET) intubation. For induction of our typical adult patient, we administered propofol (1.5 to 2 mg/kg) with fentanyl (50 to 75 μg) as a coinduction agent. We used mivacurium or rocuronium as a muscle relaxant. Either isoflurane or sevoflurane was then used to maintain the anesthetic. I also typically administered metoclopramide 5 to 10 mg as emesis prophylaxis. Our typical procedure lasted 40 minutes and recovery time was similar. Despite using short-acting muscle relaxants, we frequently found the need to reverse the effects of the muscle relaxant. Coughing and bucking in response to the ET tube were also a problem for some patients, especially smokers.