Airway management using laryngeal mask airway (LMA) in a patient in a lateral decubitus position: A case report

Rationale:Airway management of patients in a lateral decubitus position (LDP), who cannot lie supine is challenging for anesthesiologists. In a previous study, laryngeal mask airway (LMA) was found to be superior to conventional endotracheal intubation in LDP.Patient Concerns:A 38-year-old man diagnosed with type I neurofibromatosis presented with pain caused by a large hematoma (28×8cm) located in the left upper back. On arrival at the operating theater, he was in a right LDP because of the aggravation of pain in the supine position.Diagnoses:Laryngoscopy-guided endotracheal intubation was expected to be difficult in LDP.Interventions:After the induction of anesthesia, a non-inflatable LMA was introduced into the laryngopharynx with the patient in LDP. He was then maneuvered into a supine position and removal of the LMA was followed by endotracheal intubation.Outcomes:The surgery for the removal of the hematoma was performed in a prone position. The airway intubated with an endotracheal tube was well maintained during the entire surgery.Lessons:LMA is a useful device for airway management in patients in LDP who cannot lie supine.