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Updated: Jul 12, 2026

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
A two-stage approach to induction and intubation of two infants with Pierre Robin Sequence using a LMA Classic™ and
T Wesley Templeton1, Yvon F Bryan1
1Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Abstract:
The laryngeal mask airway (LMA) Classic™ and Air-Q® are supralaryngeal devices used for airway management in routine and difficult pediatric airways. We describe a novel two-stage technique of insertion of the LMA Classic™ awake prior to induction of anesthesia, to assure oxygenation and ventilation, and after induction removal and placement of the Air-Q® for intubation using the flexible fiberoptic bronchoscope. The LMA Classic's™ pliable design and relatively small size allow it to be easily placed in awake infants. In contrast, the Air-Q® is an excellent device for intubation because of its larger internal diameter and removable 9 mm adapter. Our goal was to reduce unpredictability and potentially increase the safety of induction of anesthesia and intubation in infants with Pierre Robin sequence. By using these devices in a two-stage approach we created a technique for consistent oxygenation, ventilation, and intubation in these infants.
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