14. Limitation No 1
The bowl of the LMA/ Proseal/ Fastrach/ Air Q
is large and in 6-8% of patients it may
incorporate the esophageal as well as glottic
opening predisposing to aspiration of
regurgitated material.
16. Limitation No 2
Negotiation of oropharyngeal curve by existing
LMA & its variant is at times difficult especially
when the angle of the oropharynx is <900
17. Solved by a tab on the Baska Mask which
can increase its angulation for easy
negotiation of the oropharyngeal curve
18. Limitation No 3
When suction is applied to the gastric channel
of the Proseal LM, usually nothing is sucked
out as the opening gets impinged on the
esophageal wall due to strong negative
suction.
19. Solved in Baska mask by adding a second
gastric channel which is left open to ambient
atmosphere to nearly equilibrate the
pressure in the sump cavity to atmospheric
20. Limitation No 4
The distal opening of the gastric channel is too
small for suctioning any significantly sized
particulate matter.
21. This problem is solved by enlarging
the size of gastric channel opening and
making it fish mouth type in Baska mask.
22. Limitation No 5
During the phase of emergence from
anesthesia, if patient bites on the LMA
shaft, there may be complete occlusion of the
ventilatory shaft. Second reason of occlusion of
ventilation is that the tongue impinges on the
bowl of the partly pulled LMA/Proseal LM and
occludes ventilatory passage.
23. In Baska mask, the two gastric channel will
function as ventilatory channels if the main
ventilatory channel gets occluded
24. Limitation No 6
All SGD with inflated cuff should ideally be
inflated to <60 cmH2O using a cuff pressure
inflator cum monitor or else it may
compress the capillary vessels to levels of
ischemia.
25. Baska mask is a cuffless device with a
membranous bowl which inflates with
each positive pressure and then
deflates to atmospheric levels during
passive expiration.
26. Miscellaneous Limitations of Existing
Laryngeal Mask
• Firstly, the cuff must be deflated during
insertion.
• Secondly, the airway is not secured until the
cuff is inflated.
• Thirdly, the cuff is often sub-optimally
inflated. Under or over-inflation may result in
an airway leak. Over-inflation may cause
pressure trauma to adjacent tissues.
• Fourthly, the cuff can leak.
31. Standard Placement Technique
• Lubricate the device well on both sides with
water soluble jelly.
• Place the patient’s head and neck in neutral
position. Wait for adequate depth of anesthesia.
32. Standard Placement Technique (Contd)
• Compress the proximal firmer part of the mask
between the thumb and two fingers and advance
the device towards the hard and soft palate.
33. Standard Placement Technique (Contd)
• Pull on the tab gently if needed to increase
the device curvature to negotiate the palato-
pharyngeal curve.
34. Standard Placement Technique (Contd)
• Advance till resistance is felt.
• In this position the distal tip of the device
lies in the upper part of the esophagus.
35. Standard Placement Technique (Contd)
• If gastric regurgitation is expected, connect
the suction elbow to a suction device to be
used intermittently.
36. Removal of the Baska Mask
• Wait for the patient to wake up.
• Remove the restraining adhesives, ask the
patient to open mouth.
• During device removal, keep the suction in
continuous mode.
