The Laryngeal Mask Airway – First Class on Difficult Airways

Airway management is one of the most essential skills in the practice of anesthesiology and inability to secure the airway is one of the most common reasons for major anesthesia-related complications. By far the most important recent contribution to airway management has been the introduction of the Laryngeal Mask Airway (LMA) into clinical practice. The LMA was conceived and designed by Dr. Archie Brain in the United Kingdom in 1981, and first used in a human patient the same year. The first publication regarding this device appeared in the British Journal of Anesthesia in 1983, followed by the first clinical series in 1985. Commercial production of LMA’s started in 1988 and by 1990, they were available in all hospitals with operating rooms in the United Kingdom. By the time the LMA entered the American Society of Anesthesiologists’ difficult airway algorithm (1996), it had been used in over 30 million patients. The LMA has now become an established part of routine airway management, and it is included in the routine and emergency airway management armamentarium of both hospitals and out-ofhospital emergency crews.