| The intubating laryngeal mask airway facilitates tracheal intubation in the lateral position. | |
| | |
MedLine Citation:
|
PMID: 14980953 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Although the difficulty of tracheal intubation in the lateral position has not been systematically evaluated, airway loss during surgery in a laterally positioned patient may have hazardous consequences. We explored whether the intubating laryngeal mask airway (ILMA) facilitates tracheal intubation in patients with normal airway anatomy, i.e., Mallampati grade <or=3 and thyromental distance >or=5 cm, positioned in the lateral position. We evaluated whether this technique can be used as a rescue when the airway is lost during the middle of surgery in laterally positioned patients with respect to success rate and intubation time. Anesthesia was induced with propofol, fentanyl, and vecuronium in 50 patients undergoing spine surgery for lumbar disk herniation (Lateral) and 50 undergoing other surgical procedures (Supine). Patients having disk surgery (Lateral) were positioned on their right or left sides before induction of general anesthesia, and intubation was performed in that position. Patients in the control group (Supine) were anesthetized in supine position, and intubation was performed in that position. Intubation was performed blindly via an ILMA in both groups. The time required for intubation and number and types of adjusting maneuvers used were recorded. Data were compared by the Mann-Whitney U test, Fisher's exact test, chi(2) test, or unpaired Student's t-test, as appropriate. Data presented as mean (SD). Demographic and airway measures were similar in the two groups, except for mouth opening, which was slightly wider in patients in the lateral position: 5.1 (0.9) versus 4.6 (0.7) cm. The time required for intubation was similar in each group ( approximately 25 s), as was intubation success (96%). We conclude that blind intubation via an ILMA offers a frequent success rate and a clinically acceptable intubation time (<1 min) even in the lateral position. IMPLICATIONS: Blind intubation via the intubating laryngeal mask airway (ILMA) offers frequent success and a clinically acceptable intubation time even in patients in the lateral position. |
| | |
Authors:
|
Ryu Komatsu; Osamu Nagata; Daniel I Sessler; Makoto Ozaki |
Related Documents
:
|
10812413 - Anesthetic management of the patient undergoing head and neck cancer surgery. 12958563 - Posterior cartilage graft in single-stage laryngotracheal reconstruction. 8906683 - Upper esophageal stenosis: two case reports. |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: Anesthesia and analgesia Volume: 98 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 2004 Mar |
Date Detail:
|
Created Date: 2004-02-24 Completed Date: 2004-04-01 Revised Date: 2009-11-18 |
Medline Journal Info:
|
Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
|
Languages: eng Pagination: 858-61, table of contents Citation Subset: AIM; IM |
Affiliation:
|
Department of Anesthesiology, Tokyo Women's Medical University, Tokyo, Japan. rkomatsu@pg8.so-net.ne.jp |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Aged, 80 and over Anesthesia, Inhalation Female Humans Intubation, Intratracheal / adverse effects, instrumentation*, methods Laryngeal Masks* / adverse effects Male Middle Aged Posture / physiology Supine Position / physiology |
| Grant Support | |
ID/Acronym/Agency:
|
GM061655/GM/NIGMS NIH HHS; R01 GM061655-02/GM/NIGMS NIH HHS |
| Comments/Corrections | |
Comment In:
|
Anesth Analg. 2004 Dec;99(6):1877; author reply 1877
[PMID:
15562102
]
Anesth Analg. 2004 Sep;99(3):952 [PMID: 15333444 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Assessing residual neuromuscular blockade using acceleromyography can be deceptive in postoperative ...
Next Document: Anesthetic considerations in steroid-induced mediastinal lipomatosis.