English

Abstract

BACKGROUND: Airway management plays a key role in day to day anesthesia practice. But unanticipated difficult airway and unnecessary pressor response to laryngoscopy and intubation remains a challenge to the anesthesiologist. A continuous effort has been made to develop new methods and tools to facilitate endotracheal intubation and minimize pressor response. One such device was Laryngeal Mask Airway (LMA). However, the use of LMA was associated with problems like gastric insufflation, pulmonary aspiration, inadequate ventilation and the inability to generate high inflation pressures in bronchospastic patients. Hence ILMA was introduced as an alternative. METHODS: In this prospective study, the feasibility of Intubating Laryngeal Mask Airway (ILMA) insertion and blind endotracheal intubation through ILMA was done in 100 patients undergoing various elective surgeries under general anesthesia. Only ASA Grade I and II patients with normal airway (Mallampati Class I and II) were selected. After administering conventional general anaesthesia, ILMA was inserted as per the standard technique. Blind endotracheal intubation was done through ILMA. Time required for insertion of ILMA, number of attempts required, time duration to achieve intubation and number of attempts for blind endotracheal intubation were recorded. RESULTS: Our study showed that ILMA was inserted successfully in all patients, 91% required one attempt and 9% required 2 attempts. The mean time duration for successful ILMA placement was 33.47 secs. Blind endotracheal intubation through ILMA was possible in 97% of patients, 75% required 1 attempt, 18% required 2 attempts and 4% required 3 attempts. The mean time duration for blind endotracheal tube insertion was 21.74+6.98 secs. CONCLUSION: Thus from our study it can be concluded that ILMA can be used as a blind intubation guide with a higher success rate.