The LMA-Supreme™ as an intubation conduit in patients with known difficult airways: a prospective evaluation study.

Abstract

Many extraglottic airway devices allow the direct passage of an adult-sized tracheal tube, but this is not possible with the LMA-Supreme(TM) . We evaluated the feasibility of using the LMA-Supreme(TM) as a conduit for intubation in patients with known difficult airways. Sixty-eight adult patients, with preoperative predictors of difficult intubation, were scheduled for elective surgery under general anaesthesia. After assessing the direct laryngoscopy view, 23 patients with Cormack-Lehane III/IV were included in the study. An LMA-Supreme(TM) was inserted, followed by the passage of a flexible bronchoscope loaded with an Aintree Intubation Catheter into the trachea. The bronchoscope and LMA-Supreme(TM) were removed, and a tracheal tube was railroaded over the Aintree Intubation Catheter into the trachea. Tracheal intubation was successful in all patients using the above technique. SpO(2) was >95% during the intubation procedure. We conclude that the LMA-Supreme(TM) is a successful conduit for bronchoscopic/Aintree Intubation Catheter-guided intubation in patients with known difficult airway.