Effects Of Swallowing Reflex

PHYSIOLOGY
Physiological implications The swallowing reflex Laryngeal mask airway insertion is highly successful as a blind technique as it utilizes the normal existing physiological mechanism of swallowing to follow the natural curve and the direction of the upper airway; the inserting finger imitating the tongue’s action in swallowing food. However, swallowing reflex itself must be suppressed for the insertion and then tolerance of the laryngeal mask airway cuff in the pharynx. Insertion of the laryngeal mask airway in the non-anaesthetized patient triggers a variety of protective and digestive reflexes including coughing, gagging ,retching,

No major pharyngeal trauma has been reported in several million laryngeal mask airway anaesthetic and minor morbidity, such as sore throat ,is usually mild and is less than for the endotracheal tube and similar to the face mask.24
To avoid pharyngeal mucosal damage it has been postulated that either the pressure on the pharyngeal mucosa must be lower than calculated values or the pharyngeal mucosa must be resistant to ischemic damage or adaptation of the pharyngeal blood vessels must occur either due to uneven distribution of pressure exerted by the laryngeal mask airway or to a redistribution of blood flow. A further possible consequences of pharyngeal mucosal trauma is transient bacteremia, but, in contrast to endotracheal intubation ,this does not appear to occur during laryngeal mask airway

Support for this idea comes from clinical data which suggests that laryngeal spasm, bronchospasm and coughing occur less frequently than with the endotracheal intubation. Endotracheal intubation is known to interfere with mucociliary clearance and the laryngeal mask airway does not impede mechanically, although anaesthesia itself may interfere with ciliary function. It is thus possible that the laryngeal mask airway may be of benefit in maintaining the tracheobronchial climate and this may have implication for patients with pulmonary pathology. There is clinical evidence that it may offer benefit in patients with respiratory