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Larynxmasken der zweiten Generation

Erweiterte Indikationen

Second generation laryngeal masks

Expanded indications

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Zusammenfassung

Seit der Entwicklung der klassischen Larynxmaske (LMA) in den späten 1980er Jahren nehmen deren Anwendungszahl und -gebiete kontinuierlich zu. Während Kontraindikationen beim Einsatz für elektive Eingriffe beachtet werden müssen, gibt es zunehmend klinische Untersuchungen für den Gebrauch von supraglottischen Atemwegen (SGA) bei erweiterten Indikationen, speziell für die LMA der zweiten Generation. Dieser Beitrag beschreibt die zusätzlichen Eigenschaften LMA der zweiten Generation, insbesondere im Hinblick auf die Erfüllung der Positions- und Performance-Tests. Auf der Basis der aktuell verfügbaren Studien wird der Stellenwert der Anwendung hinsichtlich der erweiterten Indikationen bei verlängerter Anwendungsdauer, laparoskopischen Operationen, Übergewicht, Bauchlage und bei der Sectio caesarea analysiert.

Abstract

Since the development of the classic laryngeal mask airway (LMA) in the late 1980s, there has been a continuous increase in the frequency of its use as well as areas of application. While contraindications to its use for elective procedures must be recognized, there are an increasing number of clinical studies on expanded indications for the use of supraglottic airway (SGA) devices, particularly those of the second generation. The present article describes the added features of the second generation LMAs, with special emphasis on the behavior of these devices in position and performance tests. An appraisal is conducted based on the currently available literature on the value of the utility for indications, such as prolonged use, laparoscopic surgery, obesity, prone position and Cesarean section.

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Abbreviations

cLMA:

LMA classic™

EGA:

extraglottische Atemwegshilfe

ETT:

Endotrachealtubus

HLP:

hypopharyngealer Leckagedruck

LMA:

Atemwegshilfe vom Typ Larynxmaske

MMV:

maximales Minutenvolumen

OLP:

oropharyngealer Leckagedruck

PLMA:

LMA-Proseal™-Larynxmaske

SGA:

supraglottische Atemwegshilfe

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A. Timmermann erhielt Unterstützung zur Durchführung von Workshops und Studien von folgenden Firmen: Ambu GmbH, Bad Nauheim; Intersurgical, Sankt; Augustin; Teleflex Medical GmbH, Kernen; VBM Medizintechnik GmbH, Sulz a. N. E.A. Nickel und F. Pühringer geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Anästhesiologie, Schmerztherapie, Intensiv- und Notfallmedizin, OP-Management, DRK Kliniken Berlin Westend und Mitte, Spandauer Damm 130, 14050, Berlin, Deutschland

    A. Timmermann DEAA, MME

  2. Klinik für Anästhesiologie und Schmerztherapie, HELIOS Klinikum Emil von Behring, Berlin, Deutschland

    E.A. Nickel

  3. Klinik für Anästhesiologie und operative Intensivmedizin, Kreiskliniken Reutlingen GmbH, Reutlingen, Deutschland

    F. Pühringer

Authors
  1. A. Timmermann DEAA, MME
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  2. E.A. Nickel
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  3. F. Pühringer
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Correspondence to A. Timmermann DEAA, MME.

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Timmermann, A., Nickel, E. & Pühringer, F. Larynxmasken der zweiten Generation. Anaesthesist 64, 7–15 (2015). https://doi.org/10.1007/s00101-014-2410-z

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