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LETTERS TO THE EDITOR

Tracheal Intubation in the Lateral Position

Medical Clinic of Hamamatsu Base, Japan Air Self Defense Force, Hamamatsu, Japan Self Defense Force Gifu Hospital, Kagamihara, Japan Department of Anesthesia, Self Defense Force Hanshin Hospital, Kawanishi, Japan

To the Editor:

We read with great interest the article by Komatsu et al. (1). The authors demonstrated that blind intubation via the intubating laryngeal mask airway (ILMA) in the lateral position was a simple and rapid method for patients with normal airway anatomy.

They emphasized the advantage of new procedure as a rescue or alternative technique when the airway is lost during the surgery in the lateral position (1,2). However, the lateral position itself prevents the laryngeal structure from collapsing, and this position is recommended in adult basic life support (3). We previously reported that fiberscopic intubation is easier in the left semilateral position (4). Therefore, we believe that lateral positioning is one of considerable methods for airway management even in the area of anesthesia.

The lateral position is unfamiliar to anesthesiologists (5). The authors might not be absolutely accustomed to the new intubating procedure during the investigation; however, the overall intubation success rates were very high and the time required for intubation was similar in the both positions, supine and lateral, despite the limitation (1). Thus, the lateral position might be recommended for applying ILMA intubation at induction of anesthesia in daily practical settings.

Tracheal intubation is one of most critical situations for airway management. Anesthesiologist should pay more attention to the safety and quality of intubation in the lateral position.

Dr. Komatsu does not wish to respond.

References

1. Komatsu R, Nagata O, Sessler DI, Ozaki M. The intubating laryngeal mask airway facilitates tracheal intubation in the lateral position. Anesth Analg 2004; 98: 858–61.[Abstract/Free Full Text]
2. Dimitriou V, Voyagis GS. Use of the intubating laryngeal mask for airway management and light-guided tracheal intubation in the lateral position. Eur J Anaesthesiol 2000; 17: 395–7.[Web of Science][Medline]
3. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care: II. Adult basic life support. JAMA 1992; 268: 2184–98.[Abstract/Free Full Text]
4. Adachi YU, Satomoto M, Higuchi H. Fiberoptic orotracheal intubation in the left semilateral position. Anesth Analg 2002; 94: 477–8.[Free Full Text]
5. Nathanson MH, Gajraj NM, Newson CD. Tracheal intubation in a manikin: comparison of supine and left lateral positions. Br J Anaesth 1994; 73: 690–1.[Abstract/Free Full Text]

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 Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Adachi, Y. U. Articles by Higuchi, H. Search for Related Content PubMed PubMed Citation Articles by Adachi, Y. U. Articles by Higuchi, H.