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LETTER TO THE EDITOR

Conventional Endotracheal Tubes for Intubation Through the Intubating Laryngeal Mask Airway

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China, xwtao_zhu{at}yahoo.com

To the Editor:

Kundra et al. (1) describe how to use various endotracheal tubes for blind intubation via the intubating laryngeal mask airway (intubating LMA). After receiving IRB approval, we studied the use of polyvinyl chloride (PVC) tracheal tubes shaped in two different ways with the intubating LMA in 200 patients, and we want to share our experience.

We used Mallinckrodt PVC endotracheal tubes and prepared them differently than described by Kundra et al. The PVC endotracheal tube is stiff and has a natural bend. We oriented the bend in two different ways when inserting it in the intubating LMA, as shown in Figure 1. As a result, the tip of the endotracheal tube emerged from the intubating LMA either at a 47° angle, or a 20° angle, depending on how the endotracheal tube was oriented during insertion. The PVC tracheal tube is firm enough that the 20° angle will increase to about 40° when mild force is applied on encountering resistance during tracheal intubation (Fig. 2).

View larger version (58K): [in this window] [in a new window]   Figure 1. The Mallinckrodt PVC tracheal tube’s (7.0-mm internal diameter) natural bend was oriented in two different ways when inserting it in the intubating LMA. As a result, the angle that the tip of the tracheal tube emerged from the intubating LMA was 47° or 20°, respectively.

View larger version (117K): [in this window] [in a new window]   Figure 2. The angle of 20° increases to 40° when mild force is applied or the tip encounters resistance during tracheal intubation.

Our study revealed that the 20° angle was associated with more frequent success for endotracheal intubation (90%) than the 47° angle (84%). It also resulted in less frequent sore throat (19% vs 26%, respectively; Table 1). The overall success rate with our method is about 87% in patients with or without difficult airway. Our experience indicates that the Mallinckrodt PVC tracheal tube can be used as successfully as the Rusch PVC tracheal tube for blind tracheal intubation through the intubating LMA (1).

REFERENCE

1. Kundra P, Sujata N, Ravishankar M. Conventional tracheal tubes for intubation through the intubating laryngeal mask airway. Anesth Analg 2005;100:284–8.[Abstract/Free Full Text]

This article has been cited by other articles:

				P. Kundra Conventional Endotracheal Tubes for Intubation Through the Intubating Laryngeal Mask Airway Anesth. Analg., January 1, 2007; 104(1): 213 - 214. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zhu, T. Search for Related Content PubMed PubMed Citation Articles by Zhu, T.

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