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Excerpt
Background and goal of study: The intubating Laryngeal Mask Airway (ILMA) is an effective ventilation device and intubation guide with potential for use in difficult tracheal intubation [1]. The aim of this prospective study was to compare the ILMA with fibreoptic intubation (FI) in patients with an anticipated difficult intubation.
Material and methods: 100 patients were randomly allocated to FI or ILMA group, in a crossover manner in case of the first technique failure (3 unsuccessful attempts). Anticipated difficult intubation was defined by the presence of at least one of the following criteria: Mallampati class (MC) >2, thyromental distance (TMD) > 65 mm or mouth opening (MO) < 35 mm, as previously reported [2]. Anaesthesia was induced with propofol (3 mg kg−1) and alfentanil (123 μg kg−1) in both groups and maintained with a continuous infusion of propofol (103 mg kg−1 h−1) (FIO = 100%). Time for tracheal intubation, between removal of the face mask and connection of the tracheal tube to the breathing system, and number of failure for each technique were recorded. Data are expressed as mean ± SD or number (%).
Results: Tracheal intubation failed in 7 cases, all being successfully intubated with the alternative technique. There was no significant difference between groups (table).
Conclusions: ILMA was as efficient as FI in patients with anticipated difficult intubation. Thus, ILMA is an alternative technique to FI allowing ventilation during intubation attempts and minimizing the risk of hypoxaemia.
Acknowledgment: This study was supported by SEBAC.
