Uvular edema was noted the evening after a surgical procedure where an LMA was used. (Image source: A & A Case Reports)

Uvular edema was noted the evening after a surgical procedure where an LMA was used. (Image source: A & A Case Reports)

Though complications related to placement of a laryngeal mask airway (LMA) are less than those related to placement of an endotracheal tube, LMA use is not wholly without complications.  For example, did you ever consider uvular swelling?

Drs. Jia Huang and Inca Chui, Department of Anesthesiology, NYU Medical Center, New York, New York, describe a six-year-old patient who was diagnosed as having uvular swelling the evening after excisional biopsy of a right facial subcutaneous mass under general anesthesia where an LMA was used.  Their case summary is described in the article “Postoperative Uvular Edema in a Child After General Anesthesia via a Laryngeal Mask Airway” published in the 15 February 2014 issue of A&A Case Reports.  The LMA was inserted with ease and an air leak was measured to be about 25 cm H2O at the start of the case.  The patient reported having a sore throat in the PACU, though he could tolerate liquids.  When the patient was seen in the evening, the physician elected to have the patient stay overnight in the ICU.  After intravenous treatment with IV dexamethasone 10 mg every 6 hours, the patient was discharged the next day on a 3-day course of oral prednisone. At a follow-up visit after 1 week, dysphagia and phagophobia had decreased.

Other reports of uvular edema have been published, though this particular complication is thought to be rare.  The point, however, is that complications can and do occur with LMA use. Airway edema can compromise the patient, particularly if the patient is a child. We must be ever vigilant.