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Intubating laryngeal mask for fibreoptic intubation — particularly useful during neck stabilization

  • Takashi Asai
  • Yoshitaka Eguchi
  • Kohei Murao
  • Tateki Niitsu
  • Koh Shingu
Reports Of Investigation

Abstract

Purpose: To assess the ease of fibrescope-assisted tracheal intubation while the patient’s head and neck were placed in the neutral or the manual in-line position, and to determine if the intubating laryngeal mask facilitated fibreoptic intubation in these positions.

Methods: In 84 patients, the patient’s head and neck were placed in the neutral position (pillow placed under occiput), and in another 40 patients the head and neck were stabilized by the manual in-line method (no pillows under occiput). In both groups, after induction of anesthesia with 2.0 – 2.5 mg·kg−1 propofol, 50 – 100µg fentanyl and 1.0 mg·kg−1 vecuronium, patients were allocated randomly into two groups: in Group C tracheal intubation was attempted using only a fibrescope, whereas in Group L fibreoptic intubation through the intubating laryngeal mask was attempted.

Results: In group C the success rate of fibreoptic tracheal intubation within two minutes was higher in the neutral position (31 of 42 patients (73%) than in the manual in-line position (8 of 20 patients (40%)). In contrast, in group L the success rate was similar between the two positions. Tracheal intubation was easier in group L than in group C (P<0.01 or 0.001) and the time for intubation was shorter in group L than in group C in both head and neck positions.

Conclusions: Fibreoptic tracheal intubation was more difficult in the manual in-line position than in the neutral position. The intubating laryngeal mask facilitated fibreoptic intubation in both positions.

Keywords

Tracheal Intubation Tracheal Tube Laryngeal Mask Airway Confidence Inter Neck Position 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif: Évaluerla facilité de l’intubation endotrachéale fibroscopique alors que la tête et le cou du patient sont en position neutre ou en position en ligne manuelle. Déterminer aussi si le masque laryngé d’intubation facilite l’intubation fibroscopique dans ces positions.

Méthode: Chez 84 patients, la tête et le cou ont été placé en position neutre (un oreiller sous l’occiput) et chez 40 autres patients, la tête et le cou ont été stabilisés manuellement par la méthode en ligne (sans oreiller). Après l’induction de l’anesthésie avec 2,0 – 2,5 mg·kg−1 de propofol, 50 – 100µg de fentanyl et 1,0 mg·kg−1 de vécuronium, les patients ont été répartis au hasard en deux groupes: le groupe C où l’intubation endotrachéale a été tentée en utilisant seulement le fibroscope, tandis que dans le groupe L, l’intubation fibroscopique a été réalisée au travers du masque laryngé d’intubation.

Résultats: Dans le groupe C, le taux de succès de l’intubation endotrachéale fibroscopique, réalisée en moins de deux minutes, a été plus élevé chez les patients en position neutre (31 des 42 patients ou 73 %) que chez les patients en ligne (8 des 20 patients ou 40 %). Par ailleurs, dans le groupe L, le taux de succès a été similaire pour les deux positions. L’intubation endotrachéale a été plus facile dans le groupe L que dans le groupe C (P<0,01 ou 0,001) et le temps nécessaire à l’intubation a été plus court dans le groupe L que dans le groupe C pour les deux positions.

Conclusion: L’intubation endotrachéale fibroscopique a été plus difficile selon la position manuelle en ligne que selon la position neutre. Le masque laryngé d’intubation a facilité l’intubation fibroscopique pour les deux positions expérimentées.

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Copyright information

© Canadian Anesthesiologists 2000

Authors and Affiliations

  • Takashi Asai
    • 1
  • Yoshitaka Eguchi
    • 1
  • Kohei Murao
    • 1
  • Tateki Niitsu
    • 1
  • Koh Shingu
    • 1
  1. 1.Department of AnesthesiologyKansai Medical UniversityMoriguchi City, OsakaJapan

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