The LMA-Supreme™ as an intubation conduit in patients with known difficult airways: a prospective evaluation study

• Published in: Acta anaesthesiologica Scandinavica Vol. 57; no. 1; pp. 77 - 81
• Main Authors: VAN ZUNDERT, T. C. R. V, WONG, D. T, VAN ZUNDERT, A. A. J
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 2013
• Subjects: Adult; Aged; Airway Management - adverse effects; Airway Management - instrumentation; Airway Management - methods; Anesthesia; Anesthesia, Inhalation; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bronchoscopy; Feasibility Studies; Female; Humans; Intubation, Intratracheal - adverse effects; Intubation, Intratracheal - instrumentation; Intubation, Intratracheal - methods; Laryngeal Masks - adverse effects; Male; Medical sciences; Middle Aged; Oxygen - blood; Prospective Studies; Human; Anesthesia; Intubation
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/aas.12011

Many extraglottic airway devices allow the direct passage of an adult-sized tracheal tube, but this is not possible with the LMA-Supreme(TM) . We evaluated the feasibility of using the LMA-Supreme(TM) as a conduit for intubation in patients with known difficult airways. Sixty-eight adult patients, with preoperative predictors of difficult intubation, were scheduled for elective surgery under general anaesthesia. After assessing the direct laryngoscopy view, 23 patients with Cormack-Lehane III/IV were included in the study. An LMA-Supreme(TM) was inserted, followed by the passage of a flexible bronchoscope loaded with an Aintree Intubation Catheter into the trachea. The bronchoscope and LMA-Supreme(TM) were removed, and a tracheal tube was railroaded over the Aintree Intubation Catheter into the trachea. Tracheal intubation was successful in all patients using the above technique. SpO(2) was >95% during the intubation procedure. We conclude that the LMA-Supreme(TM) is a successful conduit for bronchoscopic/Aintree Intubation Catheter-guided intubation in patients with known difficult airway.