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Intubation through the laryngeal mask. A technique for unexpected difficult intubation
1Anaesthetic Department, Lewisham Hospital, London.
Anaesthesia
|July 1, 1991
Summary
Blind tracheal intubation using a laryngeal mask airway was feasible in 90% of patients. However, applying cricoid pressure significantly reduced the success rate of this airway management technique.
Area of Science:
- Anesthesiology
- Airway Management
- Critical Care Medicine
Background:
- Unexpected difficulty with tracheal intubation is a significant cause of anesthetic-related mortality.
- The laryngeal mask airway (LMA) is a device that can usually be placed successfully and may facilitate intubation.
Purpose of the Study:
- To evaluate the feasibility of performing tracheal intubation through an LMA.
- To investigate the effect of cricoid pressure on the success rate of intubation via LMA.
Main Methods:
- Intubation through an LMA was attempted in 100 routine patients.
- Patients were divided into two groups: one without cricoid pressure (Group 1) and one with continuous cricoid pressure (Group 2).
Main Results:
- Successful intubation through the LMA was achieved in 90% of patients in Group 1 (no cricoid pressure).
- In Group 2, the success rate significantly decreased to 56% when cricoid pressure was maintained (p < 0.05).
Conclusions:
- Intubation through the LMA is a feasible technique for airway management.
- The application of cricoid pressure significantly impedes successful intubation via the LMA and may need to be momentarily interrupted.
- This technique is easy to learn and requires readily available equipment, suggesting its utility in failed intubation protocols.