title: [Fiberoptic intubation via laryngeal mask airway under general anesthesia in the patients with halo vest].
abstract: Since 1991, we gave anesthesia to 155 patients with halo vest. All of 128 whose airways could be kept patent by laryngeal mask airway (LMA) were successfully intubated fiberoptically via LMA using the tube exchange catheter under general anesthesia. Four patients developed airway obstruction during the induction of anesthesia, two of whom were awakened and subsequently intubated by awake fiberoptic intubation. In one patient LMA could keep the airway patent. In the other patient, cervical immobilization by halo device was released and the intubation was performed with a laryngoscope. For 8 patients, awake fiberoptic intubation was chosen from the preoperative evaluation of the positioning of head and neck. Fifteen patients were intubated with a laryngoscope without trying LMA fiberoptic intubation. No patient developed neurological injury attributed to the intubation. LMA fiberoptic intubation has several advantages. Patients do not feel discomfort under general anesthesia. Ventilation is kept continued until LMA is removed. Even less experienced residents can intubate easily and safely without assistance. However, we must carefully diagnose and select the patient whose airway can be kept patent under general anesthesia. The motionless pictures of the intubation procedures can be seen on the web site: www.hosp.go.jp/~kobe/.
authors.affiliation: Department of Anesthesia, Kobe National Hospital, Kobe 654-0155 and Chibune Hospital, Osaka 555-0001.
authors.forename: Sanji
authors.initials: S
authors.lastname: Kitamura
authors.forename: Mamiko
authors.initials: M
authors.lastname: Yamada
authors.forename: Mayumi
authors.initials: M
authors.lastname: Morikawa
authors.forename: Keiko
authors.initials: K
authors.lastname: Kamikawa
authors.forename: Katsuakira
authors.initials: K
authors.lastname: Kono
mesh_terms: D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology; D000768:Anesthesia, General; D003020:Clothing; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D017214:Laryngeal Masks; D020704:Laryngoscopes; D008297:Male; D008875:Middle Aged