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Journal of Case Reports
Intraoperative Breakage of LMA Supreme in Anticipated Difficult Airway
Anupriya Saxena,  Madhu  Gupta, Shikha  Chahar, Chitrambika P 
Department of Anesthesiology and Critical Care, ESI-PGIMSR, Basaidarapur, New Delhi, India. 
Corresponding Author:
Dr. Anupriya Saxena
Email: anupriya.pmch@gmail.com
Received: 20-JUL-2017 Accepted: 12-SEP-2018 Published Online: 20-SEP-2018
DOI: http://dx.doi.org/10.17659/01.2018.0059
Background: The laryngeal mask airway (LMA) Supreme is a single-use, second-generation supra-glottic airway device that gained popularity because of its ease of insertion and higher sealing pressure. We report a case of intra-operative LMA supreme breakage in a patient with anticipated difficult airway. Case Report: A 41 year-old female patient with anticipated difficult airway was posted for modified radical mastectomy under general anesthesia utilizing LMA Supreme. After one hour of uneventful surgery significant air leak was noticed. After excluding all possible causes of air leak, while repositioning the LMA, we noticed a break in LMA.  The airway was successfully rescued with an endotracheal tube (ETT) rail-roaded over a bougie inserted through the broken end of the LMA. The breakage could be attributed to inadvertently exerted pressure and remained unnoticed because the LMA was covered by surgical drapes. Conclusion: Continuous vigilance and preparedness to handle difficult airways throughout the procedure are essential to manage such cases.
Keywords : General Anaesthesia, Glottis, Intratracheal Intubation, Modified Radical Mastectomy.
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