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Awake insertion of the fibreoptic intubating LMA CTrach ™ in three morbidly obese patients with potentially difficult airways *
Author(s) -
Wender R.,
Goldman A. J.
Publication year - 2007
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2007.05127.x
Subject(s) - medicine , anesthesia , intubation , tracheal intubation , laryngeal masks , lidocaine , larynx , tracheal tube , airway , laryngeal mask airway , glycopyrrolate , mascara , midazolam , surgery , rapid sequence induction , sedation , atropine
Summary The Intubating Laryngeal Mask Airway (ILMA) is a supraglottic airway that facilitates ventilation and blind tracheal intubation. The LMA CTrach ™ is functionally identical to the ILMA, but has an integrated fibreoptic bundle that provides a view of the larynx. This enables visualisation of tracheal intubation while delivering 100% oxygen, with or without an inhalational anaesthetic. We report awake insertion of the CTrach in three morbidly obese patients (BMI 60–63) with known or anticipated difficult airways. Pre‐operatively, patients were given midazolam and glycopyrrolate intravenously, and then in the operating theatre the airway was anaesthetised with topical lidocaine 4%. The CTrach was inserted into the oropharynx of the still‐awake patient, the vocal cords were visualised, and anaesthetic induction was commenced with sevoflurane and spontaneous ventilation. Neuromuscular blockers were not used and we were able to see the vocal cords during the entire anaesthetic induction and intubation.