gastroparesis with DM and LMA use

[BIGphysician]

working today in the ortho feet room, anyone want to direct me to a review about when gastroparesis develops after the diagnosis of diabetes and when you shouldnt use an LMA in these patients?

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[Vaporized]

Does it matter when they have good ankle block?
It is a good question, hopefully someone knows facts. I have had attending say, if they have GERD, any other end organ issues or if 10 years for type 2. Some never use with DM.

 

[narcusprince]

This seems like a practice based question may not find much EBM data to support. As a rule of thumb I would not place an LMA with someone with GERD and constant symptoms at rest and when flat, as far as DM and Gastroperesis I would elect not to place the LMA if the surgical time is greater then 2.5 hrs, or if this patient is morbidly obese, or history of difficult airway. A good ankle block, light sedation, sudoku yada yada yada.

 

[Arch Guillotti]

working today in the ortho feet room, anyone want to direct me to a review about when gastroparesis develops after the diagnosis of diabetes and when you shouldnt use an LMA in these patients?

Probably no good EBM to guide your decision, only your gut, training, and experience.