Awake insertion of the laryngeal mask airway using topical lidocaine and intravenous remifentanil.

Abstract:

:We assessed the use of intravenous remifentanil for the insertion of the laryngeal mask airway in 10 healthy awake volunteers, a technique primarily developed to facilitate functional magnetic resonance imaging studies of anaesthesia. Each volunteer received 200 microg glycopyrronium intravenously. Topical airway anaesthesia was effected by 4 ml nebulised lidocaine 4%, followed by 12 sprays of lidocaine 10%. Remifentanil was subsequently infused to achieve an initial target effect-site concentration of 2 ng.ml(-1); increments of 1 ng.ml(-1) were allowed with the maximum effect-site concentration limited to 6 ng.ml(-1). Insertion of the laryngeal mask airway was successful on the first attempt in all cases. The median (IQR [range]) target effect-site remifentanil concentration at insertion was 2.5 (2-3 [2-4]) ng.ml(-1). All volunteers were co-operative during the procedure and only one reported discomfort. Sore throat was a complication in all volunteers. We conclude that the technique allows successful insertion of the laryngeal mask airway in healthy awake volunteers under conditions that were safe and reproducible.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Lee MC,Absalom AR,Menon DK,Smith HL

doi

10.1111/j.1365-2044.2005.04471.x

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

32-5

issue

1

eissn

0003-2409

issn

1365-2044

pii

ANA4471

journal_volume

61

pub_type

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