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LETTER TO THE EDITOR

Conventional Endotracheal Tubes for Intubation Through the Intubating Laryngeal Mask Airway

Department of Anaesthesiology and Critical Care, JIPMER, Pondicherry, Tamil Nadu, India, p_kundra{at}hotmail.com

In Response:

Dr. Zhu describes insertion of Mallinckrodt polyvinyl chloride (PVC) endotracheal tubes into the intubation laryngeal mask airway (ILMA) with the curvature aligned with the ILMA versus rotated 180° from the intrinsic curvature of the ILMA (1). He found that the nonintuitive 180° rotation yielded a higher success rate, confirming previous findings of Joo and Rose (2). Since the emergence angle changes from 20° to 40° when mild force is applied, we suggest prewarming the endotracheal tube to render it more flexible and avoiding undue application of force (3). The rate of successful tracheal intubation is likely to increase, accompanied by a lower incidence of airway trauma and sore throat. Dr. Zhu’s method is inexpensive, readily available, and useful, especially if expensive silicone wire-reinforced tubes are not available.

REFERENCES

1. Zhu T. Conventional endotracheal tubes for intubation through the intubating laryngeal mask airway. Anesth Analg 2007;104:213.[Free Full Text]
2. Joo HS, Rose KD. The intubating laryngeal mask airway with and without fiberoptic guidance. Anesth Analg 1999;88:662–6.[Abstract/Free Full Text]
3. 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]

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