The LMA Fastrach facilitates fibreoptic intubation in oral cancer patients.
OBJECTIVE
To compare ease of endotracheal intubation with the Intubating Laryngeal Mask Airway (ILMA) tracheal tube (TT; for LMA-Fastrach) and regular PVC TT (Portex) for nasotracheal fibreoptic intubation in oral cancer patients with a difficult airway.


METHODS
40 patients of physical status ASA I-II with a history of previous oral cancer surgery and/or postoperative radiotherapy scheduled for oral cancer surgery were randomly allocated by sealed envelopes to undergo tracheal intubation with either the ILMA TT or a standard TT. Ease of nasal passage of the TT and ease of tracheal intubation over the fibrescope was assessed. Peak airway pressures were assessed intraoperatively and postoperatively for 12 hr.


RESULTS
The use of the ILMA TT increased the ease of nasotracheal intubation by increasing the percentage of successful tube placements at the first attempt (80%) in comparison with standard TT (35%); (P < 0.05). Peak airway pressures were found to remain low with the ILMA TT. None of the patients experienced any airway related complications.


CONCLUSIONS
Use of a soft, flexible, nonkinking ILMA TT with a tapered tip design facilitates passage into the trachea over a fibreoptic bronchoscope and allows maintenance of lower airway pressures. The ILMA TT may be a useful adjunct for management of the difficult airway in oral cancer surgery.
Department of Anaesthesiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India. narbhat@hotmail.com
Sushma
S
Bhatnagar
Seema
S
Mishra
Rajeev Ranjan
RR
Jha
Amit K
AK
Singhal
Naresh
N
Bhatnagar
D000293:Adolescent; D000328:Adult; D000403:Airway Resistance / Q000502:physiology; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D020704:Laryngoscopes; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D011229:Preanesthetic Medication