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June 2003
Outpatient Surgery Magazine
Does LMA equal GA?
Re: "7 keys to Fast-Track Anesthesia" (March, page 52).
While Dr. Larry Grossman acknowledges that laryngeal mask airways (LMAs)
are tolerated at lighter levels of sedation, the article failed to mention
that the mere insertion of an LMA transforms a sedation or Class B anesthetic
into a Class C or general anesthetic, according to the AAAASF (a plastic
surgeon founded accreditation group). The insanity of this AAAASF proposition
means that in Florida, for instance, an anesthesiologist doing propofol-ketamine
(PK), a non-triggering anesthetic technique, who needs an LMA is then
required to have an anesthesia machine and dantrolene despite the fact
that Dr. Rebecca Twersky has clearly stated in her ASA guide to safe office
anesthesia that it is safe to give non-triggering anesthetic without an
anesthesia machine (and by inference dantrolene).
Barry L. Friedberg, M.D.
Corona del Mar, CA
narkose@cox.net
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