[Fastrach laryngeal mask and difficult intubation].
OBJECTIVE
To evaluate the success rate of intubation through the intubating laryngeal mask airway (LMA-Fastrach) in patients with predictive signs of difficult airway or after intubation failure.


METHODS
Open prospective study.


METHODS
The study included 33 adults, 21 with predictive signs of difficult airway and 12 after intubation failure.


METHODS
After induction of anaesthesia, the intubating LMA was inserted. Proper insertion was confirmed by easy bag ventilation and capnography. Intubation through the intubating LMA was then carried out with an armoured endotracheal tube. If intubation failed, a second attempt was carried out after a gentle manipulation of the intubating LMA. After two attempts, if intubation remained impossible, fibrescopic intubation through the intubating LMA was carried out. In case of failure the usual tracheal intubation algorithms were used.


RESULTS
Tracheal intubation through the intubating LMA was successful in all patients, in 32 on the first attempt and in one on the second. Successful tracheal intubation was possible on the first attempt in 25 patients (76%), on the second in four (12%) and after fibrescopic intubation through the intubating LMA in the four remaining (12%).


CONCLUSIONS
The results of this study confirm that tracheal intubation through the intubating LMA can be recommended in patients with a difficult airway, whether foreseen or not.
Cros
A M
AM
Département d'anesthésie-réanimation IV, hôpital Pellegrin-Enfants, Bordeaux, France.
Maigrot
F
F
Esteben
D
D
D000465:Algorithms; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies