M A R C H 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 2 7
reflexes have returned and the patient can open his mouth on com-
mand. But there are several factors to keep in mind regarding this
approach.
On the plus side, if you wait until patients can respond to com-
mands, they'll be awake enough to cough up secretions that may be
left behind after the LMA is removed. There may also be less risk of
laryngospasm if all reflexes are intact. Plus, patients can be success-
fully suctioned, if necessary,
with no worries about depth
of anesthesia, and the negative
effects that suctioning may
have.
But what if intubated
patients start coughing, and
don't respond to commands?
Should you leave the LMA in
until the coughing stops?
Secondly, you'll need to take
precautions when inserting
the LMA, to prevent the
patient from biting the main
tubing and preventing the pas-
sage of air. The LMA can't be
removed if teeth are tightly
clenched. Inserting a small
bite block beside the LMA, in
case patients clamp down
before they can respond to
commands, allows sufficient
Should you remove LMAs before
or after the patient wakes up?
before 63%
after 37%
SOURCE: Outpatient Surgery Magazine
InstaPoll, February 2016, n=305
InstaPoll
O
S
M
