Evaluation of the CTrach--an intubating LMA with integrated fibreoptic system

The laryngeal mask airway CTrach (CTrach) is a variant of the intubating laryngeal mask airway. It provides visualization of the larynx during intubation and is designed to increase the success rates of ventilation and tracheal intubation.

Sixty healthy anaesthetized and paralysed patients with normal airways were studied. The success rates of ventilation and intubation using CTrach were determined. Laryngeal view scoring ranged from grade I (full view of arytenoids and glottis), II (arytenoids and glottis partly visible), III (view of arytenoids, glottis or epiglottis blurred, or view clear with only epiglottis visible) to IV (no part of larynx identifiable). Adjusting manoeuvres were undertaken to improve the laryngeal view in grades II or worse.

CTrach insertion and ventilation was possible in all patients. Initial views were scored as grade I in 22 (36.7%), grade II in 14 (23.3%), grade III in 7 (11.7%) and grade IV in 17 (28.3%) patients. Adjusting manoeuvres were undertaken in 38 patients with grade II and worse (63.3%), resulting in improved views of grade I in 33 (55.0%), grade II in 18 (30.0%), grade III in 4 (6.7%) and grade IV in 5 (8.3%) patients. Tracheal intubation was successful in 58 (96.6%) patients at first attempt and in one at second. Tracheal intubation failed once.

In 60 patients with normal airways, the CTrach was used successfully for ventilation, with successful tracheal intubation in 59 patients. Tracheal intubation can be successful despite grade III or IV views.