When a patient undergoes anesthesia for surgery or a medical procedure, one of the most important concerns for the medical team is ensuring that the patient continues to breathe properly. Anesthesia can affect a person’s ability to keep their airway open and breathe on their own, so different levels of airway support may be used depending on the depth of anesthesia, the type of surgery, and the patient’s overall health.
During short procedures with light sedation, patients are typically able to breathe on their own. If necessary, medical professionals can help maintain an open airway by positioning the head and neck in a specific way. Extra oxygen may be provided through a non-invasive device, such as an oxygen mask. In other cases, a small oral or nasal airway device might be inserted to prevent the tongue from blocking the throat. These non-invasive measures are usually enough for procedures that don’t significantly impair breathing.
For deeper levels of anesthesia, patients may lose the ability to maintain their airway on their own and require more advanced airway support. In these cases, a supraglottic airway device may be used. One common type is the laryngeal mask airway, or LMA. This soft, tube-like device is inserted into the throat and rests above the vocal cords. It provides a secure way to deliver oxygen and anesthetic gases without the need for a tube to be inserted directly into the windpipe. LMAs are often used for procedures that are longer or require deeper sedation but don’t involve significant risks of vomiting or airway obstruction.
In situations where even more control is needed—such as when the patient is fully unconscious during general anesthesia—anesthesiologists may perform intubation. This involves placing a breathing tube, called an endotracheal tube, directly into the windpipe through the mouth or nose. The tube ensures that the airway remains completely open and that the lungs can be ventilated mechanically. Intubation is the most secure form of airway support and is standard for many surgeries that last a long time or involve muscle relaxants, which prevent spontaneous breathing.
In rare and emergency situations, anesthesiologists may resort to more invasive techniques. If standard methods fail to secure the airway, anesthesiologists may perform a tracheostomy, where a surgical opening is made in the neck to access the windpipe directly.
The different levels of airway support come with unique benefits and risks, and the choice of which to use is carefully made by the anesthesia team. Anesthesia providers ensure that the patient receives enough oxygen and is protected from potential complications like aspiration, where stomach contents could enter the lungs. Modern monitoring equipment and skilled professionals make these techniques very safe, and most patients are unaware of what level of airway support they received during surgery once they have awoken from sedation.
Airway management is a critical part of anesthesia care. Whether it involves simple positioning or advanced intubation, the techniques used are tailored to the patient’s needs and the type of procedure being performed. Understanding this aspect of anesthesia can help patients feel more informed and reassured about the safety measures taken while they are under sedation.