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Anesth Analg 2006;103:785
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000227162.84405.C9

LETTER TO THE EDITOR

Steven L. Shafer

More on Intubation Using the Aintree Catheter

Andrew Zura, MD, D. John Doyle, MD, PhD, Rafi Avitsian, MD, and Michael DeUngria, MD

Department of General Anesthesiology; Cleveland Clinic Foundation; Cleveland, Ohio; doylej{at}ccf.org

To the Editor:

We read with interest Dr. Rajan's comments (1) on the recent letter by Craker et al. (2). At our institution we have been using the Aintree catheter for many months in the "the cannot intubate, can ventilate" scenario (3), achieving a 100% success in more than 50 cases without complications. Given our experience, we feel that some of Dr. Rajan's comments are unduly negative. For instance, we have not experienced the difficulties he mentions related to the 56-cm long catheter. Our view is that this length is adequate for removing the laryngeal mask airway (LMA) while keeping the catheter in the trachea. Similarly, his concerns about kinking and catheter dislodgement are not reflected in our experience. Finally, with respect to his concerns about difficulties with bronchoscopy, in two instances in which we were not able to visualize the vocal cords using a 4-mm fiberscope after placement of the LMA, when we removed and reinserted the LMA, we had a clear view of the laryngeal inlet.

Finally, note that using a connector to allow mechanical ventilation permits one to carry out this technique with minimal assistance, a valuable consideration in settings where another set of skilled hands may not be available. Use of the Aintree catheter has now become a technique of choice at our institution, and we heartily recommend it to others.

Footnotes

Drs. Craker and Rajan do not wish to respond.

REFERENCES

  1. Rajan GR. Introducer catheter for fiberoptic intubation does exist. Anesth Analg 2006;102:329–30.[Free Full Text]
  2. Craker L, Allan B, Lim M. Introducer catheter for fiberoptic intubation does exist. Anesth Analg 2006;102:329.[Free Full Text]
  3. Zura A, Doyle DJ, Orlandi M. Use of the Aintree intubation catheter in a patient with an unexpected difficult airway. Can J Anaesth. 2005;52:646–9.[Web of Science][Medline]




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press