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The laryngeal mask has been widely used in clinical general anesthesia as a means of respiratory management. The mask can seal the entrance of the larynx and can be used for autonomous breathing or controlled ventilation during head and neck surgery.
Compared with mask, laryngeal mask ventilation facilitates surgical operation; Compared with endotracheal intubation, placement of the laryngeal mask does not cause emergency responses such as tachycardia and hypertension.
Laryngeal mask (Laryngeal mask airway, LMA) was designed by a British doctor Brain in 1981, according to adult throat anatomical structures have developed an artificial airway. It was officially put into production and applied in clinical practice in 1988.
The contraindications of laryngeal mask ventilation are as follows:
1. Patients with vomiting reflux aspiration or high risk, such as not fasting, full stomach, excessive intra-abdominal pressure, obesity, pregnancy over 14 weeks, intestinal obstruction, hiatal hernia
2. Multiple or large trauma, acute chest and abdomen trauma
3. Patients with larynx infection or decreased lung compliance (laryngeal mask is more oppressive to pharynx, and the sealing is still lacking).
4. Continuous positive pressure ventilation must be maintained.
5. Patients with respiratory bleeding.
6. Patients with chronic respiratory diseases with increased airway resistance and ventilation pressure greater than 25cmH2O(the maximum pressure of positive pressure breathing should not exceed 15~20cmH2O).
7. Patients with small mouth, large tongue or abnormal enlargement of tonsils (because the probability of failure of laryngeal mask application in such patients is too high, the total failure rate of laryngeal mask application can be up to 5%.