LARYNGEAL MASK AIRWAY CUFF PRESSURE AND POSITION DURING ANESTHESIA LASTING ONE TO 2 HOURS

The cuff of the laryngeal mask airway (LMA) is highly permeable to nit rous oxide (N2O), and cuff pressure increases during N2O/O-2 anaesthes ia. The extent of these changes and their effect on LMA position have previously only been investigated for short procedures. The current st udy was designed to investigate the effects of nitrous oxide-oxygen (N 2O/O-2 anaesthesia lasting one to two hours on cuff pressure, LMA posi tioning and pharyngeal morbidity. Twenty-four male patients underwent spontaneous ventilation anaesthesia with 66% N2O in oxygen and isoflur ane. Following insertion and inflation of a #4 LMA with 30 ml air, mea n (SD) cuff pressures immediately increased from 107 (9) to 145 (12) m mHg and then at a decreasing rate for 90 min to peak at 215 (12) mmHg. There was a correlation between N2O concentration and final cuff volu me (P < 0.001). There was no displacement of the LMA cuff in any patie nt. Three of 19 patients had a mild sore throat. This study demonstrat es that the increase in LMA cuff pressure is self limiting over a one- to-two-hour period and does not cause displacement of the LMA. There i s no evidence that cuff pressure monitoring and pressure limitation is necessary during LMA anaesthesia.