Laryngeal Mask Airway

WLMD ID: akfg, akff
Dr. Archie I.J. Brain (1942--) began to develop the laryngeal mask airway (LMA) in 1981. He made hundreds of prototypes and tested numerous combinations of materials, shapes, sizes and techniques of use before 1988 when the first commercial LMA became available for clinical use the United Kingdom. The LMA became available in the United States in 1992. It marked a significant advancement in the options anesthesiologists have to maintain a clear airway during anesthesia. A face mask and bag or an endotracheal tube (ET tube) were and remain the two other primary options. Whereas ET tubes enter deep into the respiratory tract, through the larynx (the opening to the big airway to the lungs) and into the trachea, LMAs sit in the space behind and around the larynx. When the situation does not require an endotracheal tube, the LMA can afford a number of advantages including producing less stress to the patient’s body and causing less coughing and throat discomfort. Also, patients need less anesthetic when an LMA is used. When compared to the use of a face mask and bag, the LMA is less likely to cause aspiration and it frees the anesthesiologist’s hands for other patient care responsibilities during the procedure. Pictured here is an example of the original reusable LMA: A #3 LMA made from medical grade silicone. To the right of the #3 LMA is a disposable one: A #2 single-use LMA made primarily of PVC and called the “LMA Unique”.

Catalog Record: Laryngeal Mask Airway

Two catalog records: akfg, akff

Access Key: akfg
Accession No.: 2004-11-17-1 A

Title: #3 laryngeal mask / [invented by Archibald I Brain] ; [manufactured by] Intavent.

Author: Brain, Archie I. J.

Title variation: Alt Title
Title: Laryngeal mask airway : #3.

Title variation: Alt Title
Title: # 3 laryngeal mask : autoclavable.

Title variation: Alt Title
Title: LMA : laryngeal mask airway.

Title variation: Alt Title
Title: LMA classic.

Publisher: [Place of manufacture not indicated] : Intavent, [1988-2008].
Physical Descript: 1 laryngeal mask airway ; silicone, other plastics ; 32 x 6 x 4.5 cm.

Subject: Laryngeal Mask Airway.
Subject: Airways.
Subject: Brain, Archie I. J.
Subject: Airway Management Equipment.

Note Type: General
Notes: Title from the airway itself.

Note Type: Citation
Notes: Brain AIJ. The laryngeal mask–a new concept in airway management. Br J Anaes
1983;55(8):801-805.

Note Type: Citation
Notes: Brain AIJ. Historical aspects and future directions. Int Anesthesiol Clin.
1998;36(2):1-17.

Note Type: Citation
Notes: Brimacombe J. The advantages of the LMA over the tracheal tube or facemask: a
meta-analysis. Can J Anaesth. 1995;42(11):1017-1023.

Note Type: Citation
Notes: Brodrick PM, Webster NR, Nunn JF. The laryngeal mask airway. A study of 100
patients during spontaneous breathing. Anaesthesia. 1989;44(3):238-241.

Note Type: Citation
Notes: Sood J. Laryngeal mask airway and its variants. Indian J Anaesth.
2005;49(4):275-280.

Note Type: Citation
Notes: Verghese C, Berlet J, Kapila A, Pollard R. Clinical assessment of the single
use laryngeal mask airway–the LMA-unique. Br J Anaesth. 1998;80(5):677-679.

Note Type: Citation
Notes: Yu SH, Beirne OR. Laryngeal mask airways have a lower risk of airway
complications compared with endotracheal intubation: a systematic review. J
Oral Maxillofac Surg. 2010;68(10):2359-2376.

Note Type: Physical Description
Notes: One laryngeal mask airway made mostly of medical grade silicone; It consists
of a small mask attached to a gently curved tube that resembles an
endotracheal tube; The mask ioval shaped, more narrow at the most proximal
end and more broad at the distal end; The mask is also opaque and rimmed with
with an inflatable cuff; A thin inflation line, approximately 3 mm in
diameter and 23.5 cm in length, exits the distal end of the mask; At the most
distal end of the line is a navy blue inflation balloon and port; The tip of
the port is white; The proximal end of the curved tube (hereafter called
“airway tube”), which resembles an endotracheal tube, connects to an opening
in the interior of the mask; Two thin support bars run across the opening in
the mask where it connects to the airway tube; The airway tube is transparent
and approximately 1.5 cm in diameter and 18 cm in length when straightened; A
black line runs longitudinally onlong the tube’s posterior curve; Markings on
the ube include (but are not limited to) “3250365”, “#3 LARYNGEAL MASK”,
“AUTOCLAVABLE”, “INTAVENT”, AND “B”.

Note Type: Reproduction
Notes: On January 14, 2013 the LMA described here was photographed, by Mr. Steve
Donisch, to the left of a #2 LMA Unique.

Note Type: Historical
Notes: In 1981 Dr. Archie I.J. Brain began to develop the laryngeal mask airway
(LMA). He made hundreds of prototypes and tested numerous combinations of
materials, shapes, sizes and techniques of use before 1988 when the first
commercial LMA became available for clinical use the United Kingdom. In 1992,
the LMA became available for clinical use in the United States. Its
development marked a significant advancement in the options anesthesiologists
have to maintain a clear airway during anesthesia. The use of a face mask and
bag or an endotracheal tube (ET tube) were and remain the two other primary
options. Whereas ET tubes enter deep into the respiratory tract, through the
larynx and into the trachea, LMAs sit in the space behind and around the
larynx. When the situation does not require an endotracheal tube, the LMA
can afford a number of advantages including producing less stress to the
patient’s vital signs and causing less coughing and throat discomfort. Also,
less anesthetic drugs are needed to anesthetize patients when an LMA is used.
When compared to the use of a face mask and bag, the LMA is less likely to
cause aspiration and it frees the anesthesiologist’s hands for other patient
care responsibilities. LMAs have proven particularly useful for a number of
situations including for short surgical procedures, for the management of the
difficult airway, and for paramedics and physicians in emergency situations.
After the introduction of the original reusable LMA, Dr. Brain designed
variations that address specific needs, including the “LMA Flexible,” an LMA
with a wire reinforced airway tube designed to prevent kinking of the tube,
the “LMA Fastrach,” designed to aid in endotracheal intubation, and the “LMA
Unique,” a disposable LMA for single-use.

Note Type: Exhibition
Notes: Selected for the WLM website (noted February, 2013).

Access Key: akff
Accession No.: 2008-04-29-1 A

Title: LMA | unique / [invented by Archibald I Brain] ; [manufactured by] LMA.
Author: Brain, Archie I. J.
Corporate Author: LMA.

Title variation: Alt Title
Title: LMA : unique.

Title variation: Alt Title
Title: Laryngeal mask airway : unique.

Title variation: Alt Title
Title: LMA unique.

Title variation: Alt Title
Title: Laryngeal mask airway : #2, single-use.

Publisher: [Singapore] : LMA, [1998-2008].
Physical Descript: 1 laryngeal mask airway ; PVC, other plastics ; 32 x 4 x 4.5 cm

Subject: Laryngeal Mask Airway.
Subject: Airways.
Subject: Brain, Archie I. J.
Subject: Airway Management Equipment.

Note Type: General
Notes: Title from the airway itself. Place of manufacture and expiration date from
original package as described in the accession record.

Note Type: With
Notes: Blister package. Markings on package include, ‘Made in Singapore’, and an
hourglass symbol indicating the expiration date of “06/2009”.

Note Type: Physical Description
Notes: One latex free laryngeal mask airway made mostly of PVC; It consists of a
small mask attached to a gently curved tube that resembles an endotracheal
tube; The mask is oval shaped, more narrow at the most proximal end and more
broad at the distal end; The mask is rimmed with with an inflatable cuff; A
thin inflation line, approximately 2 mm in diameter and 22.2 cm in length,
exits the distal end of the mask; At the most distal end of the line is an
inflation balloon and port; Connected to the port is a red, rectangular
plastic lock that is marked with, “REMOVE [new line] BEFORE [new line] USE”;
The proximal end of the curved tube (hereafter called “airway tube”), which
resembles an endotracheal tube, connects to an opening in the interior of the
mask; Two thin support bars run across the opening in the mask where it
connects to the airway tube; The airway tube is approximately 1.5 cm in
diameter and 15.7 cm in length when straightened; Markings on the side of the
airway tube include (but are not limited to) “LMA | Unique”, “20-30 kg”, “Air
14 ml/60 cm H2O”, “# 2 1/2”, “SINGLE USE”, a symbol indicating that the
airway is latex free, and “LMA [new line] The Laryngeal Mask Company
Limited”; A black dotted line runs longitudinally onlong the tube’s posterior
curve.

Note Type: Reproduction
Notes: Displayed in a WLM case exhibit located on the second floor of the Park Ridge
ASA headquarters building. On January 14, 2013, the LMA described here was
photographed, by Mr. Steve Donisch. to the right of a #3 laryngeal mask
airway marked with “Intavent”.

Note Type: Historical
Notes: In 1981 Dr. Archie I.J. Brain began to develop the laryngeal mask airway
(LMA). He made hundreds of prototypes and tested numerous combinations of
materials, shapes, sizes and techniques of use before 1988 when the first
commercial LMA became available for clinical use the United Kingdom. In 1992,
the LMA became available for clinical use in the United States. Its
development marked a significant advancement in the options anesthesiologists
have to maintain a clear airway during anesthesia. The use of a face mask and
bag or an endotracheal tube (ET tube) were and remain the two other primary
options. Whereas ET tubes enter deep into the respiratory tract, through the
larynx and into the trachea, LMAs sit in the space behind and around the
larynx. When the situation does not require an endotracheal tube, the LMA
can afford a number of advantages including producing less stress to the
patient’s vital signs and causing less coughing and throat discomfort. Also,
less anesthetic drugs are needed to anesthetize patients when an LMA is used.
When compared to the use of a face mask and bag, the LMA is less likely to
cause aspiration and it frees the anesthesiologist’s hands for other patient
care responsibilities. LMAs have proven particularly useful for a number of
situations including for short surgical procedures, for the management of the
difficult airway, and for paramedics and physicians in emergency situations.
After the introduction of the original reusable LMA, Dr. Brain designed
variations that address specific needs, including the “LMA Flexible,” an LMA
with a wire reinforced airway tube designed to prevent kinking of the tube,
the “LMA Fastrach,” designed to aid in endotracheal intubation, and the “LMA
Unique,” a disposable LMA for single-use.

Note Type: Exhibition
Notes: Displayed in a WLM case exhibit located on the second floor of the Park Ridge
ASA headquarters building;Selected for the WLM website (noted February, 2013).