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Awake insertion of the laryngeal mask airway using topical lidocaine and intravenous remifentanil *
Author(s) -
Lee M. C.,
Absalom A. R.,
Me D. K.,
Smith H. L.
Publication year - 2006
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2005.04471.x
Subject(s) - remifentanil , medicine , lidocaine , anesthesia , laryngeal mask airway , sore throat , airway , larynx , volunteer , laryngeal masks , complication , surgery , propofol , agronomy , biology
Summary 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 μg 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.