LMA vs ETT

[fakin' the funk]

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I'm curious, when you do this for these "borderline" cases what's the breakdown on how many are:

"Oh ****, that guy still had a lot in his stomach"

vs

"Eh, guess I didn't need to do that"

Majority are pretty empty stomachs.

But I *really* like *really* empty stomachs.

 

[sevoflurane]

I don't like the way they seat as well. I will use them from time to time but I have never tried to place an OG down one. If I want to suction that stomach at all, I'm placing an ETT, period.
I guess if you couldn't intubate for some reason and had to go with an LMA then possibly it would be an option but I've never been in that situation.

Truth.

 

[sevoflurane]

We are 4 pages into this....

The point is that you CAN use LMAs for most of your cases w/ appropriate indications. ETT is a personal preference and how you, as an anesthesiologist, want to carry out your anesthetic.

I'm an LMA guy, mainly because I like a spontaneously ventilating patinet, reduces atelectasis, all i have to do is pull out the lma and place a mask.... but that doesnt't mean I'm going to drown them in narcotics and inhaled agents to get them there. Again, it depends on the case.

.5 mac + whtever is not necessaraly easily achieved with an ETT vs. LMA.

DOGMA: 2+ hour case needs an ETT... BS.

Sugammadex might make it easier... but you still need to intubate and extubate.

 

[sevoflurane]

What's the goal? get them to pacu quickly, low N/V, simple anesthetics, awake and talking when you get to pacu without any bucking or AW hyperactivity???

The case will determine the anesthetic of choice, LMA vs ETT isn't really about the AW device, but how you leave your patient in pacu.