A case report of upper airway obstruction following long-term use of LMA in surgery

Laryngeal spasm is the narrowing or complete closure of the glottis due to the reflex contraction of the laryngeal muscles. The present study reports a case of upper airway obstruction following long-term use of a laryngeal mask in surgery.

A 45-year-old female patient who referred to a urologist due to urological problems with complaints of urinary bleeding and pain in the urogenital area. Based on trusting the surgeon's words about the shortness of the surgery, a laryngeal mask (LMA) was used for the patient, and propofol was used to anesthetize the patient during the operation. The patient's surgery gradually took longer due to suspicion of malignancy in the urinary tract and bladder, and the surgeon extended the surgery almost every 15 minutes. Finally, the surgery was completed after nearly three hours, and despite the fact that the patient had not taken any special medicine except propofol an hour before the end of the operation, but when he woke up, he had difficulty breathing. After about 30 minutes passed and the conditions were suitable, we extubated the patient with special precautions and transferred him to the intensive care unit for recovery and for further assurance.

Based on the results of the present study, long-term use of laryngeal mask is associated with the occurrence of laryngospasm after surgery, which can be considered as a result of long-term stimulation of the upper airway by the laryngeal mask.