• Paola Hurtado, Neus Fàbregas, Carolina Forero, Javier Tercero, Enrique Carrero, Nicolas de Riva, Isabel Gracia, Anna M Lopez, and Ricard Valero.
• Anesthesiology Department, Hospital Clínic de Barcelona, Barcelona, Spain.
• J Neurosurg Anesthesiol. 2017 Jul 1; 29 (3): 317-321.

BackgroundThis study describes our experience with laryngeal mask (LM) inserted after anesthetic induction in patients already in knee-chest position for lumbar neurosurgery.MethodsAirway management (need for LM repositioning, orotracheal intubation because of failed LM insertion), anticipated difficult airway, and airway complications were registered. Statistics were compared between groups with the t test or the χ test, as appropriate.ResultsA total of 358 cases were reviewed from 2008 to 2013. Tracheal intubation was performed in 108 patients and LM was chosen for 250 patients (69.8%). Intubated patients had a higher mean age and rate of anticipated difficult airway; duration of surgery was longer (P<0.001, all comparisons). LM insertion and anesthetic induction proved effective in 97.2% of the LM-ventilated patients; 7 patients (2.8%) were intubated because of persistent leakage. Incidences with airway management were resolved without compromising patient safety.ConclusionLM airway management during lumbar neurosurgery in knee-chest position is feasible for selected patients when the anesthetist is experienced.

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