[Use of the flexible laryngeal mask in rheumatoid arthritis with the patient in lateral decubitus position].

Rheumatoid arthritis is a chronic inflammatory disease leading to synovitis and joint deformities. The hands are often affected but in some cases there may be involvement of the temporomandibular, the atlantoaxial, and cricoarytenoid joints. For insertion of the mask, a patient may be placed in supine, lateral, or prone position with minimal complications. A 46-year-old woman with long-standing rheumatoid arthritis and mild atlantoaxial joint involvement was programed for removal of a large tumor from soft tissue near the right scapula. She was placed on her left side for surgery. After induction of anesthesia a flexible laryngeal mask was inserted without shifting her spinal column. At the end of the procedure, the mask was removed without complications and she orally assessed pain as 0. The flexible laryngeal mask can be used in patients with rheumatoid arthritis with little need to move the cervical spine. Insertion can take place in lateral decubitus position, thus avoiding movements that might worsen the patient's underlying disease.