MKT ( MUST KNOW TOPICS) : INSTRUMENTS IN ANESTHESIA :
Drugs and Instruments in Pre-Anesthesia Evaluation LMA (Laryngeal mask airway ) / SAD (Supraglottic
Anesthesia airway device )
Monitoring in Anesthesia Cardiopulmonary Scientist who invented it - Archie Brain
resuscitation
Types of LMAs : ( Active recall – try to identify and
recall important points about each of these )
First generation LMA LMA, Fast trach LMA or Intubating LMA
•• Example – LMA classicQ •• Important features - They have airway tube
and gastric tube
•• Important features - single tube present
(airway tube ), which can be used for ventilation •• They create a better seal with the larynx than
only - Demerit : cannot prevent aspiration first generation LMAs
•• They are safer and protects better against
Second generation LMA aspiration
•• Examples - LMA supreme, Proseal LMA, I gel
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Cerebellum Quick Revision Notes
LMA CLASSIC PROSEAL LMA
•• It is made up of Silicone
•• It is reusable / non disposable
•• Pilot balloon is present
•• It forms a good seal with the larynx preventing
aspiration of gastric contents. Hence, it is
called as ‘Proseal’
It is the LMA preferred for Day care Surgery /
Laproscopic Surgery
•• First generation LMA
•• Important features - single tube present
(airway tube )
•• Demerit : cannot prevent aspiration
LMA supreme
I - gel LMA
•• Main identification feature – It does not have
a pilot balloon
•• It is made up of Thermoelastic polymer
•• Second generation LMAQ
•• Disposable
Fast track LMA or Intubating LMA
•• Made up of Silicone
•• Non disposable
•• Can be used upto 40 times
•• Pilot Balloon is present Recommended size of the laryngeal mask airway
according to the patient's body weightQ.
•• It has a special endotracheal tube used for
intubating ‘through’ the LMA Size Patient's weight
1 <5 kg
•• It is sterilized by Autoclaving
1.5 5-9 kg
2 10-19 kg
2.5 20-29 kg
3 30-49 kg
4 50-69 kg
5 Large adult, 70-100 kg
Ideal patient position preferred for intubation :
Sniffing the morning air position / barking dog
position Q
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Anesthesia
Flexion of
cervical spine
Extension of
atlanto
occipital joint
Flexion at Atlantoaxial joint and extension at Atlanto- MacIntosh laryngoscope
occipital joint •• It has a Curved blade
Steps of Intubation •• It is used in Adults
1. Insert the Laryngoscope in the right corner of
the mouth
2. Sweep the tongue from right to leftQ
3. Then lift the laryngoscope
4.
Once the vocal cords are seen pass the
endotracheal tube
5. Inflate the cuff of the endotracheal tube and
connect the anesthesia circuit
6. Confirm intubation by capnography (gold standard) McCoy laryngoscopeQ
or by auscultation or chest XrayQ •• It has a curved blade with a lever which helps in
lifting the epiglottis
Identification of types of
laryngoscope: (Active recall) •• It is used for difficult intubation
Millers laryngoscope
•• It has a straight blade
•• It is used in pediatric patients