Laryngeal Mask Airway: A Postoperative Sore Throat Clinical Practice Guideline

One of the most common and preventable complications experienced by patients undergoing general anesthesia is a postoperative sore throat (POST). Up to 70% of patients who receive a laryngeal mask airway (LMA) during anesthesia suffer from POST. Despite its regular occurrence and designation as a minor complication, POST has proven to be a distressing complication for patients afflicted. Consequently, a perceived minor complication can, in fact, play a major role in a patient’s perception of their care, the skill of their anesthesia provider, and their overall satisfaction with their experience.Evidence shows that inflation of LMA cuffs beyond the recommended 60cm H20 could play a prominent role in the development of POST due to the high pressures exerted on oropharyngeal structures. A thorough review of current evidence demonstrates that evidence-based interventions are available to providers that can significantly reduce the incidence and/or severity of POST. In the case of overinflated LMA cuffs, the use of manometers immediately after LMA insertion allows the provider to adjust cuff pressures to ensure that an adequate seal is maintained while remaining below the maximum recommended pressures.Utilizing the evidence, this project sought to make a policy recommendation to a panel of experts at a medium-sized regional hospital in southeast Mississippi. After presenting this information to the panel as well as other anesthesia staff, an evaluation tool was used to collect feedback and recommendations regarding the policy recommendation. After analyzing the feedback, it was determined that the panel and staff were amenable to implementation of a policy requiring manometry monitoring on any patient undergoing general anesthesia with an LMA. A policy recommendation and executive summary were constructed to be presented to the panel for the possibility of implementation at their facility.