Complete separation of the tube from the mask of a reusable classic laryngeal mask airway: a case report

The laryngeal mask airway (LMA) is an important addition to the anesthetist''s equipments. However, its usage may involve some complications. We have encountered an unusual and potentially serious complication using this equipment. A 45-year old man underwent cataract surgery under general anesthesia. After the induction of anesthesia, a size 4 of the reusable classic LMA was inserted without any difficulties and the cuff was inflated. After a little manipulation, the proximal tube of the LMA was separated from the distal part, leaving the distal mask inside the pharynx. The exit of the remaining portion of the LMA was very difficult and made the ventilation of the patient impossible. The patient’s oxygen saturation decreased to 40%. The remaining portion of the LMA was removed by a great clamp and with an extreme effort. Then, an endotracheal tube was inserted and the patient was ventilated with 100% oxygen. After 6 hours, the patient was discharged with no apparent complications. The autoclave was used several times for the sterilization of the LMA.