Best Practice Policy Recommendation of Laryngeal Mask Airway Manometry Usage to Reduce Intra-operative Complications

Laryngeal mask airway (LMA) devices are a vital aspect of modern anesthesia practice. Unfortunately, even the simplest of airway management devices can lead to the development of negative pharyngeal-laryngeal patient consequences by over-inflation of the cuff on the LMA device. While these airway injuries are certainly harmful to the patient, they are preventable. With the utilization of manometry monitoring intra-operatively, the potential occurrences of these postoperative complications can be decreased, leading to better patient care and higher satisfaction for the healthcare facility and its stakeholders.The current practice of measurement for LMA intra-cuff pressure intra-operatively is largely subjective, and there is still currently no standard in place for ideal monitoring of these intra-cuff pressures for safe usage. The purpose of this doctoral project was to further identify discrepancies among anesthesia providers to determine assessment methods among providers and the barriers to the implementation of manometry usage to providers in practice. The doctoral project utilized evidence identified in the review of the literature to develop a best practice policy to encourage increased manometry monitoring usage intra-operatively in order to reduce post-operative complications from increased LMA intra-cuff pressures to present to a clinical affiliate, which is a facility that offers clinical experience for student nurse anesthetists, lacking such a policy. An anonymous Qualtrics© survey was disseminated to Mississippi CRNAs concerning LMA intra-cuff assessment methods. The data was collected, and the survey was analyzed for common themes and differences. From this data and an extensive literature review, a best practice policy was created. An educational module with the proposed best practice policy was also prepared and presented to the doctoral project committee for final suggestion on the effectiveness of the educational module if the doctoral project information was of high quality, and if the proposed best practice policy would benefit a clinical affiliate of The University of Southern Mississippi (USM).